Clinic
Seneca Health Services, INC.
Seneca Health Services, INC. was paid $14.15M by Medicaid between Jan 2018 and Nov 2024, across 17 billing codes. Its largest line is H0004, Behavioral health counseling and therapy, per 15 minutes — 35% of everything it billed.
33Billing provider infoSENECA HEALTH SERVICES, INC.
MAXWELTON, WV 24957
MAXWELTON, WV 24957
33aNPI1154532513assigned 05/25/2007
28Total paid$14.15M
24GClaims135,713
24DCodes billed17
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Mental Health Clinic/Center (Including Community Mental Health Center) providers in West Virginia
Rank by total paid#2 of 27
Median peer was paid$583K
This provider vs. median24×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 10,528 | $877K | |
| 2019 | 5,527 | $507K | |
| 2020 | 19,612 | $2.04M | |
| 2021 | 21,481 | $2.27M | |
| 2022 | 32,079 | $3.91M | |
| 2023 | 28,452 | $2.96M | |
| 2024incomplete | 18,034 | $1.58M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 35% | 46,403 | 25,520 | $4.94M |
| H0031 | Mental health assessment, by non-physician | 19% | 16,026 | 14,064 | $2.70M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 19% | 48,383 | 42,929 | $2.69M |
| H0036 | Community psychiatric support and treatment, per 15 minutesCommunity psychiatric supportive treatment, face-to-face, per 15 minutes | 17% | 7,316 | 1,354 | $2.40M |
| H2036 | Alcohol and/or other drug treatment program, per diem | 6.2% | 4,208 | 271 | $876K |
| H0038 | Self-help/peer services, per 15 minutes | 1.1% | 3,544 | 1,376 | $162K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 1.1% | 1,940 | 1,792 | $155K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 863 | 821 | $91K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 858 | 820 | $61K |
| 80305 | <1% | 3,829 | 3,027 | $40K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,686 | 1,492 | $15K |
| Q3014 | Telehealth originating site facility fee | <1% | 313 | 290 | $8K |
5 more codes
| T1017 | Case management, billed per 15 minutes | <1% | 240 | $8K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 12 | $1K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 65 | $1K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 12 | $292.41 |
| 81025 | <1% | 15 | $94.95 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialVAUGHAN, MARCIE (PRESIDENT CEO)
Parent organizationSENECA HEALTH SERVICES, INC.
| Provider | Location | Paid |
|---|---|---|
| Seneca Health Services INC | Maxwelton, WV | $38.08M |
| Seneca Health Services INC | Maxwelton, WV | $2.76M |
| Seneca Health Services, INC. | Summersville, WV | $24K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.