Agency
Potomac Highlands Mental Health Guild, INC.
Potomac Highlands Mental Health Guild, INC. was paid $17.12M by Medicaid between Jan 2018 and Dec 2024, across 11 billing codes. Its largest line is T1019, help at home with bathing, dressing and eating, billed per 15 minutes — 76% of everything it billed.
33Billing provider infoPOTOMAC HIGHLANDS MENTAL HEALTH GUILD, INC.
PETERSBURG, WV 26847
PETERSBURG, WV 26847
33aNPI1992714398assigned 08/05/2006
33bProvider typeDevelopmentally Disabled Services Day Training Agency
28Total paid$17.12M
24GClaims65,104
24DCodes billed11
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Developmentally Disabled Services Day Training Agency providers in West Virginia
Rank by total paid#3 of 19
Median peer was paid$2.18M
This provider vs. median7.9×
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 | 10,703 | $2.96M | |
| 2019 | 6,670 | $2.41M | |
| 2020 | 10,320 | $2.68M | |
| 2021 | 8,863 | $2.36M | |
| 2022 | 9,494 | $2.99M | |
| 2023 | 10,708 | $2.17M | |
| 2024incomplete | 8,346 | $1.55M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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) | 76% | 9,008 | 8,106 | $13.00M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 14% | 20,354 | 12,186 | $2.35M |
| H0031 | Mental health assessment, by non-physician | 4.2% | 4,879 | 4,276 | $713K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.6% | 17,312 | 12,631 | $618K |
| T1002 | Rn services, up to 15 minutes | 1.0% | 9,588 | 9,038 | $173K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 1,757 | 1,496 | $151K |
| 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% | 2,067 | 1,666 | $109K |
| H0038 | Self-help/peer services, per 15 minutes | <1% | 58 | 40 | $5K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 31 | 24 | $2K |
| T1001 | Nursing assessment / evaluation | <1% | 31 | 16 | $2K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 19 | 16 | $867.08 |
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 officialCURTIS, S. (CEO)