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

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

Southwest Behavioral Health Services Inc (NPI 1144384389)

Field	Value
Entity Type	Organization
Organization	Southwest Behavioral Health Services Inc
Address	3450 N 3rd St
City	Phoenix
State	AZ
ZIP	85012
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 21, 2006

Payer Source	Total Paid
Medicaid	$83.5M
Medicare	$0

Key Findings

This provider is effectively single‑payer at scale: there is no Medicare billing on file, while lifetime Medicaid revenue is $83.5M, indicating the organization is funded almost entirely through Medicaid rather than a mixed Medicare/Medicaid model. Analysts should treat Medicaid flows as the primary revenue and utilization lens for this entity.

Revenue is highly concentrated in a small set of service codes: H0004 ($30.7M, 36.9%), T1016 ($18.9M, 22.7%), and H0031 ($9.5M, 11.5%) together account for 71.1% of the provider’s total Medicaid revenue. This concentration shows the business is driven by a few high-volume service lines rather than a broad, evenly distributed code mix.

The code mix and dollar/claim profiles point to a community behavioral health operating model centered on time‑based therapy and care coordination: H0004 (behavioral health counseling, per 15 minutes) and T1016 (case management, per 15 minutes) are the two largest drivers by revenue and volume, while H0031 (mental health assessment by non‑physician) provides higher per‑claim reimbursement but fewer claims. The presence of H0025 ($7.8M, prevention education), H2017 ($2.9M, psychosocial rehabilitation), and H0018 ($2.6M, short‑term residential per diem) further supports a mix of outpatient therapy, case management, and some residential/rehab services.

Competitive standing within Arizona is dominant for the top service lines: H0004 ranks #1 of 1147 providers in-state (100th percentile; extreme outlier), T1016 ranks #3 of 1157 (100th percentile; extreme outlier), and H0031 ranks #2 of 812 (100th percentile; extreme outlier). Multiple other codes also sit at very high percentiles (for example, H2014 at #2 of 783, 100th percentile; 90792 at #7 of 484, 99th percentile), indicating the provider is a major statewide player in community behavioral health.

Utilization patterns show very high volumes of short‑interval services alongside fewer higher‑paid assessments: top code claim counts include H0004 at 557.8K claims with $55 avg paid/claim, T1016 at 1M claims with $18 avg paid/claim, and H0031 at 89.9K claims with $106 avg paid/claim. This mix suggests an operational model that relies on high throughput of time‑based unit services supplemented by assessment visits.

Many of the provider’s high-volume lines are labeled as statistical outliers in-state—several top codes are termed “extreme outlier” or “notably above typical state volume”—which indicates utilization patterns that are far above peers rather than modest participation. From a payer or contracting perspective, those outlier lines (notably H0004, T1016, H0031, and H2014) represent the most material levers for network negotiation, utilization review, or care‑management alignment.

The provider’s tenure supports its scale: the NPI was enumerated 2006-12-21 (~20 years ago), indicating a long‑established presence in the Arizona behavioral health market. Combined with $83.5M in Medicaid revenue and top‑code dominance, the organization appears to be an entrenched community behavioral health operator rather than a new entrant.

Beyond the top three codes, the billing profile includes a mix of service types and payment models—per‑15‑minute therapy and case management (low‑to‑mid per‑claim amounts, high volume), per‑diem short‑term residential (H0018 at $171 avg paid/claim, 15.3K claims), and episodic E/M visits (e.g., 99214 at $3.5M revenue). This breadth implies the provider delivers a range of community behavioral services from routine counseling and case management to assessments and short‑term residential care, with most revenue concentrated in the high‑volume outpatient counseling and case management lines.

Medicaid: Complete Services Breakdown

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

60 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	557,770	$60	$30.7M
T1016	Case management, each 15 minutes	1,049,980	$20	$18.9M
H0031	Mental health assessment, by non-physician	89,950	$110	$9.5M
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	312,580	$30	$7.8M
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…	69,520	$50	$3.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	7,250	$400	$2.9M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	15,350	$170	$2.6M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	14,160	$110	$1.6M
H2014	Skills training and development, per 15 minutes	243,830	$10	$1.2M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	14,410	$80	$1.1M

Showing 1–10 of 60

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Southwest Behavioral Health Services Inc — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

60 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	36	360	430	$320	$2.3M
H2010	Comprehensive medication services, per 15 minutes	36	80	71,620	$10	$1.7M
S9485	Crisis intervention mental health services, per diem	32	40	1,010	$100	$1.5M
T1016	Case management, each 15 minutes	3	1,160	2,110	$30	$1.2M
S0215	Non-emergency transportation; mileage, per mile	22	510	4,610	$40	$1.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	1	1,150	1,700	$90	$1M
H2017	Psychosocial rehabilitation services, per 15 minutes	22	270	600	$410	$983.9K
H2016	Comprehensive community support services, per diem	293	290	840	$280	$890.1K
H2014	Skills training and development, per 15 minutes	2	780	1,610	$100	$868.2K
H2027	Psychoeducational service, per 15 minutes	13	500	750	$170	$592.2K

Showing 1–10 of 60

Related Providers

Other providers that share a Tax Identification Number (TIN) with Southwest Behavioral Health Services Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwest Behavioral Health Services, Inc.	AZ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.4M
Raymond W Lemberg Phd PC	AZ	Psychologist	$0	$7.5M
Southwest Behavioral Health Services,inc.	AZ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6M
Raymond Lemberg	AZ	Psychologist	$92.7K	$0
Mary Zemansky	AZ	Clinical Psychologist	$47.6K	$0
Marci Haines	AZ	Clinical Psychologist	$5.3K	$0

Nearby Providers

Other providers in the same ZIP code as Southwest Behavioral Health Services Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Park Health Center	AZ	Federally Qualified Health Center (FQHC)	$0	$351.5M
The Tungland Company, LLC	AZ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$332M
Adelante Healthcare, Inc.	AZ	Federally Qualified Health Center (FQHC)	$0	$245.5M
Banner-university Medical Group	AZ	Multi-Specialty Clinic/Center	$0	$133.7M
Prileo Healthcare LLC Dba Prileo Home Care	AZ	In Home Supportive Care Agency	$0	$88.8M
Denova Collaborative Health, LLC	AZ	Multi-Specialty Clinic/Center	$0	$87.9M
Terros, Inc.	AZ	Community/Behavioral Health Agency	$0	$81.7M
Accentcare At Home, Inc.	AZ	In Home Supportive Care Agency	$0	$65.7M
Banner Physician Super Specialists Arizona LLC	AZ	Multi-Specialty Clinic/Center	$0	$36.9M
Banner - University Hospital Based Physicians LLC	AZ	General Acute Care Hospital	$0	$29.7M

Southwest Behavioral Health Services Inc — Billing Profile & Reimbursement Data

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Southwest Behavioral Health Services Inc — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References