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

Why is the Medicaid comparison limited to Wyoming 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. Wyoming (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 Counseling Service (NPI 1215007083)

Field	Value
Entity Type	Organization
Organization	Southwest Counseling Service
Address	1124 College Dr
City	Rock Springs
State	WY
ZIP	82901
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	November 9, 2006

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-focused behavioral health clinic: there is no Medicare billing on file, and total Medicaid revenue is $1.5M, indicating a single-payer footprint concentrated in state Medicaid rather than a mixed Medicare/Medicaid practice. The absence of Medicare billing combined with the Medicaid revenue level positions the organization as a community-focused provider rather than a Medicare-dependent outpatient clinic.

Revenue is highly concentrated: the top three Medicaid codes (H2019, H2017, 99213) account for 82.4% of the provider’s total Medicaid revenue. H2019 alone represents $662.8K (45.2% of Medicaid revenue) and H2017 represents $440.4K (30.0%), so these two programmatic codes drive the majority of billing and financial performance.

The code mix indicates the provider’s primary service lines are short-interval therapeutic and rehabilitative behavioral health services. High-volume use of H2019 (Therapeutic behavioral services, per 15 minutes: 10K claims, $66 avg paid/claim, $662.8K revenue) and H2017 (Psychosocial rehabilitation services, per 15 minutes: 6K claims, $73 avg paid/claim, $440.4K revenue) suggests an operational model based on frequent, time-based units of care rather than primarily long medical visits. This pattern is consistent with community mental health centers or intensive outpatient behavioral programs.

Telehealth services are a significant component of access and reimbursement: Q3014 (Telehealth originating site facility fee) appears as a meaningful revenue source with 3.7K claims, $19 avg paid/claim, $70.8K revenue (4.8% of Medicaid revenue) and it ranks #2 of 17 providers in-state (94th percentile). That rank and volume indicate the provider is an early and substantial adopter of originating-site telehealth billing within the state Medicaid system.

The provider is a dominant statewide performer for psychosocial rehabilitation: H2017 ranks #1 of 9 providers in-state (100th percentile) and is described as "notably above typical state volume for this code." This ranking indicates market leadership for that specific programmatic service and suggests competitive advantage or specialization in psychosocial rehabilitation within the state.

For therapeutic behavioral services the provider also shows unusually high state-level volume: H2019 ranks #7 of 171 providers in-state (96th percentile) and is described as "notably above typical state volume for this code." Given H2019’s contribution of $662.8K (45.2% of Medicaid revenue), this high rank reinforces that the organization is a major local provider of time-based therapeutic services.

Standard outpatient E/M usage is present but secondary to programmatic behavioral codes: 99213 accounts for 2.2K claims, $47 avg paid/claim, $105K revenue (7.2% of Medicaid revenue) and ranks #53 of 257 (80th percentile), while 99212 accounts for 3.1K claims, $30 avg paid/claim, $91.8K revenue (6.3% of Medicaid revenue) and ranks #2 of 70 (99th percentile). These patterns show routine office-based clinical follow-up is part of the care mix, with especially high relative state volume for lower-complexity visits (99212).

Long-tenured enrollment and modest overall scale point to an established community provider: the NPI was enumerated 2006-11-09 (~20 years ago), and total Medicaid revenue of $1.5M suggests a small-to-midsize program. Combined with concentrated revenue by a few programmatic codes and high in-state ranks for those codes, the data depict a stable, specialty-focused behavioral health center that commands leading share on select Medicaid service lines in Wyoming.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2019	Therapeutic behavioral services, per 15 minutes	10,040	$70	$662.8K
H2017	Psychosocial rehabilitation services, per 15 minutes	6,030	$70	$440.4K
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…	2,240	$50	$105K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3,060	$30	$91.8K
Q3014	Telehealth originating site facility fee	3,730	$20	$70.8K
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…	690	$60	$41.6K
G9012	Other specified case management service not elsewhere classified	1,240	$20	$28.6K
T1017	Targeted case management, each 15 minutes	500	$30	$15.4K
H0038	Self‑help/peer services, per 15 minutes	490	$20	$9.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Southwest Counseling Service — 3 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2019	Therapeutic behavioral services, per 15 minutes	7	170	840	$80	$192.2K
G9012	Other specified case management service not elsewhere classified	11	40	460	$50	$97.8K
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…	96	220	400	$50	$79.3K
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…	53	260	420	$30	$67.2K
H2017	Psychosocial rehabilitation services, per 15 minutes	1	10	120	$70	$66.9K
T1017	Targeted case management, each 15 minutes	8	20	240	$40	$57.9K
H0038	Self‑help/peer services, per 15 minutes	5	20	170	$30	$13K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2	70	70	$20	$10.2K
Q3014	Telehealth originating site facility fee	2	20	220	$20	$10K

Nearby Providers

Other providers in the same ZIP code as Southwest Counseling Service, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lsw, LLC	WY	Developmentally Disabled Services Day Training Agency	$0	$11.6M
Able Hands	WY	Developmentally Disabled Services Day Training Agency	$0	$9.6M
Sweetwater Pediatrics P.C.	WY	Primary Care Clinic/Center	$0	$2M
Pain Care Center, LLC	WY	Pain Medicine (Anesthesiology) Physician	$0	$1.6M
Qrc LLC	WY	Case Management Agency	$0	$1.4M
University Of Utah Adult Services	WY	Emergency Medicine Physician	$0	$1.2M
Lcr Dental Rock Springs LLC	WY	Dentist	$0	$1.1M
Memorial Hospital Of Sweetwater County	WY	Internal Medicine Physician	$0	$1.1M
Aai Services LLC	WY	Case Management Agency	$0	$971.4K
Nicole Armstrong	WY	Case Manager/Care Coordinator	$0	$773.2K

Southwest Counseling Service — Billing Profile & Reimbursement Data

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Southwest Counseling Service — 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