Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or West Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to West Virginia only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. West Virginia (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Appalachian Psychiatric Services PLLC (NPI 1982056404)

Appalachian Psychiatric Services PLLC is a psychiatry physician provider located in Beckley, West Virginia. This profile covers 0 Medicare and 20 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Appalachian Psychiatric Services PLLC
Address	1014 Johnstown Rd
City	Beckley
State	WV
ZIP	25801
Taxonomy	Psychiatry Physician
NPI Enumerated	July 8, 2016

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	39,980	$40	$1.8M
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	15,240	$20	$365.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	5,970	$60	$334.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8,070	$40	$330.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,600	$100	$163.3K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	2,320	$60	$148.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,220	$70	$144.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	2,000	$40	$88.2K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	780	$110	$81.5K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	1,190	$40	$51.1K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. West Virginia Distribution

Appalachian Psychiatric Services PLLC — 3 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	50	1,270	1,240	$30	$245K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	28	190	660	$40	$226.4K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	329	1,030	890	$50	$221K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	20	130	200	$70	$82.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	5	90	200	$30	$78.8K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	23	100	120	$100	$69.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	105	190	110	$70	$63.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	13	210	280	$40	$59.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	160	200	490	$30	$57.7K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	11	90	250	$50	$55.5K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Raleigh General Hospital LLC	WV	General Acute Care Hospital	$0	$36.4M
Community Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$35M
Fmrs Health Systems Inc	WV	Community/Behavioral Health Agency	$0	$27M
Health Care Alliance, Inc.	WV	Emergency Medicine Physician	$0	$25M
Jan-care Ambulance Of Raleigh County Inc	WV	Land Ambulance	$1.9M	$20.8M
Appalachian Regional Healthcare, Inc	WV	General Acute Care Hospital	$0	$18.3M
Raleigh County Commission On Aging, Inc.	WV	Home Health Agency	$0	$16.7M
Mountain State Home Health Care Inc	WV	Nursing Care Agency	$0	$16.5M
Family Options Providers, LLC.	WV	Community/Behavioral Health Agency	$0	$16.1M
Raleigh County Commission On Aging, Inc.	WV	Home Health Agency	$0	$13.8M

Appalachian Psychiatric Services PLLC — Billing Profile & Reimbursement Data

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Appalachian Psychiatric Services PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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