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

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

Vallivue School District #139 (NPI 1174677603)

Field	Value
Entity Type	Organization
Organization	Vallivue School District #139
Address	5207 S Montana Ave
City	Caldwell
State	ID
ZIP	83607
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	January 22, 2007

Payer Source	Total Paid
Medicaid	$17M
Medicare	$0

Key Findings

VALLIVUE SCHOOL DISTRICT #139 is effectively a Medicaid-centric billing entity with no Medicare billing on file and $17M in lifetime Medicaid revenue; this indicates the district’s clinical billing activity is concentrated entirely in the Medicaid program rather than split across Medicare and Medicaid. The absence of Medicare claims suggests services are delivered primarily to children and younger populations typical of a Local Education Agency.

Revenue is highly concentrated in a small set of service codes: the top three Medicaid codes (H0004, H2017, 96152) account for 78.0% of the provider’s total Medicaid revenue. H0004 alone represents $7.7M (45.4% of Medicaid revenue) and H2017 contributes $4.1M (24.1%), so a few high-volume behavioral-health and assessment line items drive the majority of dollars.

The dominant codes (H0004 – behavioral health counseling and therapy, per 15 minutes; H2017 – psychosocial rehabilitation services, per 15 minutes) point to a service model built around frequent, short-interval therapy and rehabilitation sessions consistent with school-based behavioral health programs. 96152 appears among the top three but is listed without a description in the data; its placement as an 8.5% revenue contributor suggests an important assessment or testing component complements the therapy and rehabilitation work.

Competitive standing by code shows the district is a strong statewide participant for key behavioral-health services: H0004 ranks #10 of 157 providers (94th percentile) and H2017 ranks #17 of 135 (88th percentile), indicating above-average scale in these Medicaid service lines within Idaho. By contrast 96152 ranks #18 of 73 (76th percentile), a more modest but still meaningful position for that line item.

Several psychological/assessment codes are reported as notably above typical state volume, signaling a relative specialty in testing and evaluation: 96131 (rank #2 of 23, 95th percentile), 96137 (rank #2 of 25, 96th percentile), 96130 (rank #3 of 30, 93rd percentile), and 96136 (rank #3 of 27, 92nd percentile) are all flagged as notably above typical state volume. This cluster of high-ranked testing codes, together with the therapy codes, implies the district provides both assessment and follow-up therapeutic services at scale.

Speech and rehabilitative services form a meaningful secondary service line: 92508 has 34.2K claims with $9 avg paid/claim and $307.6K revenue (1.8% of Medicaid revenue) and ranks #5 of 91 providers (96th percentile), while 92507 has 15.6K claims, $25 avg paid/claim and $389.2K revenue (2.3% of Medicaid revenue) and ranks #27 of 210 (88th percentile). These high claim counts and strong state rankings indicate robust group and individual speech-language activity consistent with school-based therapy programs.

The provider’s operational footprint is characterized by very high claim volumes and generally low per-claim payments for many front-line codes (for example, H0004: 39.6K claims at $195 avg paid/claim; 92508: 34.2K claims at $9 avg paid/claim), which is consistent with a model of frequent, short-duration units of service (per 15-minute billing) delivered in an educational setting. This suggests programmatic emphasis on recurrent, time-based therapy and counseling rather than infrequent, high-dollar procedures.

VALLIVUE’s NPI has been enumerated since 2007-01-22 (~19 years ago), indicating a long-standing billing presence in Medicaid; combined with the concentrated revenue mix and above-average state ranks in behavioral health and testing codes, this tenure supports the view that the district has established school-based clinical programs and administrative capacity to sustain ongoing Medicaid billing.

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
H0004	Behavioral health counseling and therapy, per 15 minutes	39,640	$200	$7.7M
H2017	Psychosocial rehabilitation services, per 15 minutes	15,240	$270	$4.1M
96152	N/A	6,710	$220	$1.4M
H2014	Skills training and development, per 15 minutes	27,480	$40	$1.1M
T1019	Personal 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…	20,520	$20	$431K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	15,570	$30	$389.2K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	34,180	$10	$307.6K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	1,500	$200	$296.6K
99412	The provider offers advice on maintaining and improving health to a group of patients for roughly an hour.	6,240	$40	$224.7K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	5,690	$40	$216K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Vallivue School District #139 — 3 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal 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…	36	100	11,400	$80	$2M
H0004	Behavioral health counseling and therapy, per 15 minutes	10	160	4,020	$140	$1.6M
G9002	Coordinated care fee, maintenance rate	41	40	11,630	$40	$913.2K
H2017	Psychosocial rehabilitation services, per 15 minutes	17	140	2,000	$110	$633.3K
H2014	Skills training and development, per 15 minutes	6	60	2,500	$60	$613.3K
H2019	Therapeutic behavioral services, per 15 minutes	49	60	2,960	$120	$609.8K
96152	N/A	18	70	2,270	$80	$608.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	67	280	1,480	$70	$389.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	27	210	3,020	$50	$389K
H0005	Alcohol and/or drug services; group counseling by a clinician	44	80	2,240	$50	$257.3K

Showing 1–10 of 23

Nearby Providers

Other providers in the same ZIP code as Vallivue School District #139, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Smiles 4 Kids Caldwell	ID	Pediatric Dentistry	$0	$8.5M
Canyon County Ambulance District	ID	Ambulance	$950.5K	$7.4M
Patrick Waite	ID	General Practice Dentistry	$0	$1.1M
Southwest District Health	ID	Public Health or Welfare Agency	$0	$809.5K
Canyon Creek Developmental Services	ID	Local Education Agency (LEA)	$0	$791K
Mobilitycares LLC	ID	Optometrist	$0	$492.2K

Vallivue School District #139 — Billing Profile & Reimbursement Data

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Vallivue School District #139 — 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