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 Oregon for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oregon 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. Oregon (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.

Wallowa Valley Center For Wellness (NPI 1043249907)

Field	Value
Entity Type	Organization
Organization	Wallowa Valley Center For Wellness
Address	606 Medical Pkwy
City	Enterprise
State	OR
ZIP	97828
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	July 2, 2006

Payer Source	Total Paid
Medicaid	$18.9M
Medicare	$0

Key Findings

WALLOWA VALLEY CENTER FOR WELLNESS has no Medicare billing on file and reports $18.9M in lifetime Medicaid revenue, making Medicaid effectively the sole publicly billed payer observed in this dataset. This single-payer profile concentrates the provider’s reported public reimbursement exposure entirely within Medicaid.

Revenue is extremely concentrated: the precomputed top three Medicaid codes account for 99.3% of the provider’s total Medicaid revenue, and a single code, T1020, represents $18.5M or 97.4% of Medicaid revenue. That concentration indicates the organization’s financial footprint in Medicaid is driven almost entirely by one service line.

The dominant code, T1020 (Personal care services, per diem), suggests the provider operates primarily as a per-diem personal care services provider under individualized plans of treatment rather than as a short-visit psychotherapy or medical E/M clinic. Secondary codes by revenue — H2018 (psychosocial rehabilitation services, per diem) at $291.6K and T1040 (Medicaid certified community behavioral health clinic services, per diem) at $72.6K — are present but account for a small fraction of total receipts.

Competitive standing within Oregon is mixed: T1020 ranks #15 of 44 providers in-state (67th percentile), indicating a solid but not dominant position for this high-revenue personal care service. By contrast, H2018 ranks #3 of 13 providers in-state (83rd percentile), showing relatively strong placement among peers for psychosocial rehabilitation despite that code producing only 1.5% of the provider’s Medicaid revenue; T1040 is more modest at #7 of 12 (45th percentile).

Payment-per-claim patterns drive the revenue profile: T1020 has an average paid/claim of $7587, which is the primary driver of the $18.5M revenue tied to that code, while H2018 averages $89/claim and T1040 averages $168/claim. These differences indicate the provider’s Medicaid revenue is driven by high per-diem payments for T1020 rather than by high volumes of lower-paid service units.

Although the provider bills a range of behavioral health CPT/HCPCS codes (for example, H0004: 1.5K claims; 90837: 1.4K claims; 99214: 791 claims), those services collectively contribute only small shares of total Medicaid revenue. This pattern reinforces that traditional therapy and E/M encounters are secondary revenue streams relative to per-diem personal care services for this organization.

Several codes show sizable claim volumes but report $0 average paid/claim and therefore $0 reported revenue — notably H0039 with 12.1K claims, H0038 with 479 claims, and H2023 with 40 claims. The presence of non-revenue claims at scale is a notable feature of the billing profile and may reflect alternative payment or reporting arrangements in the data rather than fee-for-service reimbursements.

The provider’s NPI was enumerated on 2006-07-02 (~20 years ago), indicating an established operating tenure in the market that aligns with a sustained Medicaid billing relationship focused on per-diem personal care services.

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1020	Personal care services, per diem, 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…	2,430	$7,590	$18.5M
H2018	Psychosocial rehabilitation services, per diem	3,280	$90	$291.6K
T1040	Medicaid certified community behavioral health clinic services, per diem	430	$170	$72.6K
H0004	Behavioral health counseling and therapy, per 15 minutes	1,510	$40	$57.3K
H0005	Alcohol and/or drug services; group counseling by a clinician	990	$30	$29.6K
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	420	$30	$13.5K
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…	790	$10	$6.3K
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…	620	$10	$5.6K
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…	750	$10	$4.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,420	$1	$2.8K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Wallowa Valley Center For Wellness — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1020	Personal care services, per diem, 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…	15	40	1,330	$1,170	$6.4M
H2018	Psychosocial rehabilitation services, per diem	3	10	1,350	$180	$2M
H0005	Alcohol and/or drug services; group counseling by a clinician	122	180	3,250	$40	$783.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	144	270	1,660	$90	$681K
T1040	Medicaid certified community behavioral health clinic services, per diem	7	10	840	$190	$608.3K
H0038	Self‑help/peer services, per 15 minutes	100	150	1,030	$80	$417.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	386	1,380	540	$140	$363.3K
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…	693	1,500	650	$70	$312.4K
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…	730	1,590	590	$50	$236.5K
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…	304	400	230	$90	$153.8K

Showing 1–10 of 23

Nearby Providers

Other providers in the same ZIP code as Wallowa Valley Center For Wellness, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pioneer Guest Home Ii, Inc	OR	Mental Illness Community Based Residential Treatment Facility	$0	$2.9M
James Bailey	OR	Optometrist	$95.7K	$0
Billie Kaskasuto	OR	Family Nurse Practitioner	$53K	$0
John Suto	OR	Sports Physician Chiropractor	$33.3K	$0
Elizabeth Powers	OR	Family Medicine Physician	$7.5K	$0

Wallowa Valley Center For Wellness — Billing Profile & Reimbursement Data

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Wallowa Valley Center For Wellness — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References