Agency
Cumberland Behavior Group, LLC
Cumberland Behavior Group, LLC was paid $15.12M by Medicaid between Jan 2018 and Dec 2021, across 5 billing codes. Its largest line is T2016, a day of residential support for a person with a developmental disability — 87% of everything it billed.
33Billing provider infoCUMBERLAND BEHAVIOR GROUP, LLC
SOMERSET, KY 42503
SOMERSET, KY 42503
33aNPI1184944100assigned 06/02/2010
33bProvider typeCase Management Agency
28Total paid$15.12M
24GClaims95,344
24DCodes billed5
24AFirst – last monthJan 2018 – Dec 2021
Compared with peers
Next to other Case Management Agency providers in Kentucky
Rank by total paid#13 of 94
Median peer was paid$3.21M
This provider vs. median4.7×
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 | 28,942 | $4.24M | |
| 2019 | 30,080 | $4.04M | |
| 2020 | 20,821 | $3.77M | |
| 2021 | 15,501 | $3.07M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T2016 | A day of residential support for a person with a developmental disabilityHabilitation, residential, waiver; per diem | 87% | 73,482 | 2,691 | $13.12M |
| T2021 | Day program for adults with developmental disabilities, per 15 minutesDay habilitation, waiver; per 15 minutes | 6.9% | 16,525 | 1,016 | $1.04M |
| T1019 | Help at home with bathing, dressing and eating, billed per 15 minutesPersonal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) | 3.0% | 1,272 | 52 | $452K |
| 97535 | Self-care/home management training, each 15 minutes | 2.6% | 3,185 | 296 | $389K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | <1% | 880 | 533 | $116K |
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 officialJONES, ACE (EXECUTIVE DIRECTOR)