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

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

Skull Valley Health Care (NPI 1255943569)

Field	Value
Entity Type	Organization
Organization	Skull Valley Health Care
Address	1929 N Aaron Dr
City	Tooele
State	UT
ZIP	84074
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	August 18, 2020

Payer Source	Total Paid
Medicaid	$25.8M
Medicare	$0

Key Findings

SKULL VALLEY HEALTH CARE is effectively a single-payer Medicaid provider with no Medicare billing on file; Lifetime Medicare revenue is reported as none while Lifetime Medicaid revenue is $25.8M, indicating the organization’s patient mix and reimbursement footprint are concentrated entirely in Medicaid for the period on file. This positioning suggests the clinic’s services are targeted toward populations primarily covered by state Medicaid rather than fee-for-service Medicare beneficiaries.

Revenue is highly concentrated in a small set of service lines: the precomputed top three Medicaid codes account for 94.6% of the provider’s total Medicaid revenue. In practice that concentration means financial performance and operational capacity are tightly linked to a few core service types rather than a broad portfolio of billed activities.

The dominant revenue driver is H0018 (short-term residential behavioral health, per diem), which generated $19.8M or 76.8% of the provider’s Medicaid revenue and represents the bulk of clinical activity dollars. The code-volume profile (32.5K claims at a $610 avg paid/claim) and the high share of total revenue indicate the facility functions largely as a short-term residential treatment program where per-diem residential services are the primary business line.

Complementary to its residential focus, the provider bills significant amounts for H2017 (psychosocial rehabilitation services, per 15 minutes) and 90853 (group psychotherapy), which together with H0018 make up the 94.6% top-three revenue share. H2017 produced $2.6M (10.1% of Medicaid revenue) and 90853 produced $2.0M (7.7% of Medicaid revenue), reflecting an operational mix that pairs residential care with time-based rehabilitation and group therapy programming.

On in-state competitive standing, SKULL VALLEY ranks as a sizable but not market-dominant provider for its top codes: it ranks #4 of 30 providers in the state for H0018 (90th percentile), which signals a strong presence in residential treatment locally; by contrast, it is #24 of 94 for H2017 (75th percentile) and #50 of 150 for 90853 (67th percentile), both described as typical, unremarkable volumes relative to peers. These rank/percentile placements indicate the organization is an important regional provider for residential services while maintaining typical volumes for rehabilitation and group psychotherapy relative to other in-state providers.

The provider’s NPI was enumerated on 2020-08-18 (~6 years ago), establishing at least a multi-year operational tenure during which the provider built a concentrated Medicaid revenue base around residential behavioral health. This tenure aligns with the heavy weighting toward H0018 and indicates the business model has been stable enough since enumeration to generate the reported $25.8M in Medicaid revenue.

Service-mix details and lower utilization of typical ambulatory E/M codes further emphasize the residential/behavioral specialization: lower-dollar E/M entries such as 99211 ($205.5K, 548 claims) and infrequent higher-level office visits like 99214 ($74.7K, 162 claims) constitute a small fraction of revenue. That pattern supports the interpretation that routine outpatient primary care is not the provider’s core revenue driver and that resources and billing workflows are centered on behavioral health treatment modalities.

Several ancillary behavioral health codes appear at modest volumes (e.g., H0006 case management $316.1K, H0038 peer services $31.4K), indicating the program supplements residential care with case management and peer-support elements rather than operating as a broad-based outpatient provider. Given the very high reliance on H0018, any policy, reimbursement, or utilization changes affecting per-diem residential reimbursement would disproportionately affect this provider’s financial performance.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	32,520	$610	$19.8M
H2017	Psychosocial rehabilitation services, per 15 minutes	4,330	$600	$2.6M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	3,890	$510	$2M
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…	1,290	$580	$741.2K
H0006	Alcohol and/or drug services; case management	650	$490	$316.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	550	$380	$205.5K
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…	160	$460	$74.7K
H0038	Self‑help/peer services, per 15 minutes	50	$600	$31.4K
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,…	40	$390	$13.5K
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…	20	$650	$12.4K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Skull Valley Health Care — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

12 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	4	30	1,340	$330	$5.8M
H2017	Psychosocial rehabilitation services, per 15 minutes	24	90	340	$70	$713.8K
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…	145	370	690	$140	$704.2K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	50	150	1,060	$70	$528.1K
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…	107	110	270	$120	$439.4K
H0038	Self‑help/peer services, per 15 minutes	43	50	680	$70	$325.3K
H0006	Alcohol and/or drug services; case management	27	40	1,300	$40	$215.9K
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…	89	90	270	$70	$200.4K
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…	716	1,340	200	$80	$144K
99354	N/A	14	10	370	$70	$97K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Skull Valley Health Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tooele Hospital Corporation	UT	General Acute Care Hospital	$0	$11.6M
Nat-su Behavioral Health LLC	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.3M
Skull Valley Health Clinic	UT	Clinic/Center	$0	$4.5M
Ambulance Services Of Tooele, LLC	UT	Land Ambulance	$372.1K	$3.4M
Goshute Health Care LLC	UT	Clinic/Center	$0	$2.9M
Patrick Green Md PLLC	UT	Primary Care Clinic/Center	$0	$1.8M
Tooele County School District	UT	Local Education Agency (LEA)	$0	$1.4M
Tooele Clinic Corp	UT	Family Medicine Physician	$0	$1.3M
Jim J. Gould, Md PC	UT	Clinic/Center	$0	$1.2M
Nat-su Health Care LLC	UT	Clinic/Center	$0	$1.1M

Skull Valley Health Care — Billing Profile & Reimbursement Data

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Skull Valley Health Care — 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