Clinic
Roane County Family Health Care, INC.
Roane County Family Health Care, INC. was paid $6.44M by Medicaid between Jan 2018 and Dec 2024, across 62 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 91% of everything it billed.
33Billing provider infoROANE COUNTY FAMILY HEALTH CARE, INC.
SPENCER, WV 25276
SPENCER, WV 25276
33aNPI1861494528assigned 08/12/2005
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$6.44M
24GClaims139,980
24DCodes billed62
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in West Virginia
Rank by total paid#23 of 205
Median peer was paid$521K
This provider vs. median12×
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 | 18,666 | $935K | |
| 2019 | 11,916 | $541K | |
| 2020 | 28,988 | $1.24M | |
| 2021 | 22,181 | $947K | |
| 2022 | 21,909 | $987K | |
| 2023 | 19,412 | $956K | |
| 2024incomplete | 16,908 | $829K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 91% | 62,760 | 46,423 | $5.89M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.7% | 27,010 | 23,189 | $241K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.1% | 10,427 | 8,678 | $73K |
| 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% | 3,904 | 3,639 | $41K |
| 90674 | <1% | 958 | 905 | $28K | |
| 81002 | <1% | 1,993 | 1,789 | $26K | |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 3,046 | 1,789 | $15K |
| 80305 | <1% | 2,567 | 1,476 | $15K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,634 | 1,579 | $11K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 753 | 671 | $8K |
| 92551 | <1% | 976 | 931 | $8K | |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 377 | 206 | $7K |
50 more codes
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 2,369 | $7K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 426 | $6K |
| 99173 | <1% | 1,129 | $6K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 304 | $6K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 639 | $5K |
| 90670 | <1% | 264 | $5K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 773 | $4K |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 409 | $4K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 395 | $4K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 386 | $3K |
| 90632 | <1% | 71 | $3K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 209 | $3K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 186 | $3K |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 83 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 224 | $2K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 271 | $2K |
| 3045F | <1% | 43 | $2K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 294 | $2K |
| 3044F | <1% | 150 | $2K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 280 | $1K |
| 82947 | <1% | 232 | $1K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 372 | $1K |
| 90633 | <1% | 93 | $583.95 | |
| 20610 | <1% | 13 | $443.62 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 138 | $237.08 |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 766 | $122.62 |
| 87428 | <1% | 2,361 | $83.55 | |
| 3046F | 0% | 54 | $0.00 | |
| 99307 | 0% | 623 | $0.00 | |
| 3725F | 0% | 188 | $0.00 | |
| 92552 | 0% | 35 | $0.00 | |
| 90715 | 0% | 62 | $0.00 | |
| 90648 | 0% | 28 | $0.00 | |
| 90734 | 0% | 72 | $0.00 | |
| 3077F | 0% | 13 | $0.00 | |
| 3078F | 0% | 41 | $0.00 | |
| 90686 | 0% | 610 | $0.00 | |
| G0467 | Community health center visit, returning patient | 0% | 6,756 | $0.00 |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 0% | 1,163 | $0.00 |
| 85018 | 0% | 184 | $0.00 | |
| 90651 | 0% | 44 | $0.00 | |
| 3075F | 0% | 17 | $0.00 | |
| 90680 | 0% | 39 | $0.00 | |
| 90723 | 0% | 29 | $0.00 | |
| 87807 | 0% | 21 | $0.00 | |
| 99441 | 0% | 19 | $0.00 | |
| 3351F | 0% | 53 | $0.00 | |
| 3074F | 0% | 13 | $0.00 | |
| 90656 | 0% | 58 | $0.00 | |
| 99308 | Subsequent nursing facility care, per day, straightforward | 0% | 573 | $-103.58 |
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 officialARNOLD, STACEY (BILLING SUPERVISOR)
Parent organizationROANE COUNTY FAMILY HEALTH CARE, INC.