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.

Southwest Center (NPI 1285688515)

Field	Value
Entity Type	Organization
Organization	Southwest Center
Address	474 W 200 N
City	St George
State	UT
ZIP	84770
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicaid	$58.3M
Medicare	$0

Key Findings

SOUTHWEST CENTER is effectively a Medicaid-focused mental health clinic: it has no Medicare billing on file and reports $58.3M in lifetime Medicaid revenue, indicating its patient population and reimbursement footprint are concentrated in Medicaid-managed care and fee-for-service programs rather than Medicare-enrolled services. The absence of Medicare activity suggests the organization primarily serves younger populations or Medicaid-covered behavioral health caseloads rather than Medicare-eligible older adults.

Revenue concentration is high and concentrated in a small set of services: the precomputed top 3 Medicaid codes account for 49.2% of the provider’s total Medicaid revenue, signaling that roughly half of its Medicaid income is driven by a narrow set of high-volume behavioral health services. This level of concentration implies that shifts in reimbursement or utilization for those codes would materially affect the provider’s financial performance.

Psychotherapy services are the single largest revenue driver: code 90837 alone accounts for $18.8M (32.2% of Medicaid revenue) and places SOUTHWEST CENTER at rank #4 of 372 in-state (99th percentile), an extreme outlier in state volume for this code. Together with 90834 and other psychotherapy codes (90847, 90853, 90832), the mix shows the organization operates a high-volume psychotherapy practice offering individual, family, and group therapy, emphasizing longer-session psychotherapy.

The provider delivers a broad range of community and rehabilitative behavioral health services beyond psychotherapy: high volumes of H2014 (skills training), H2017 (psychosocial rehabilitation), T1017 (targeted case management), and H0046 (mental health services NOS) together account for multi-million dollar revenue contributions and reflect integrated community support, case management, and rehabilitative program operations. These codes’ presence at measurable volumes indicates SOUTHWEST CENTER provides both clinical psychotherapy and substantive community-based psychosocial supports.

Competitive standing in-state is strong for several key codes: multiple codes show top-quartile or extreme rankings — 90837 (99th percentile, extreme outlier), 90791 (98th percentile, notably above typical), 90834 (96th percentile, notably above typical), and 90847 (99th percentile, extreme outlier) — demonstrating the center is a dominant regional provider for core psychiatric evaluation and psychotherapy services. For other community-service codes ranks are high but more typical (e.g., H2014 at 93rd percentile, H2017 at 94th), indicating the provider is among leading but not singularly dominant vendors for rehabilitative services.

Operational implications follow from high-volume, time-based service mix: large claim counts for time-based codes (90837: 107.3K claims; H2017: 44.8K claims; T1017: 39.3K claims) imply substantial clinician-hours and program capacity for ongoing psychotherapy and group/rehab sessions. The payer and code mix suggests staffing models weighted toward therapists, case managers, and psychosocial rehabilitative staff rather than procedure- or technology-heavy investments.

Tenure and market presence: SOUTHWEST CENTER’s NPI was enumerated around 2006-05-20 (~20 years ago), indicating long-term operational presence in the market which is consistent with the sustained high-volume Medicaid billing observed across multiple service lines. This longevity likely supports established referral relationships and program infrastructure that enable the observed high volumes.

Risk to revenue from code concentration: because nearly half of Medicaid revenue derives from the top three codes (precomputed 49.2%), changes in state Medicaid policy, prior authorization, or utilization management targeted at high-volume psychotherapy or evaluation codes could disproportionately impact the center’s revenue. Diversification across additional service lines appears present but the revenue mix remains heavily reliant on a few high-volume therapy and evaluation codes.

Medicaid: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	107,290	$180	$18.8M
H2014	Skills training and development, per 15 minutes	29,060	$180	$5.3M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	19,940	$230	$4.6M
H2017	Psychosocial rehabilitation services, per 15 minutes	44,840	$100	$4.6M
T1017	Targeted case management, each 15 minutes	39,270	$110	$4.4M
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…	34,540	$130	$4.3M
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…	21,320	$190	$4M
H0046	Mental health services, not otherwise specified	33,040	$100	$3.4M
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	16,150	$150	$2.5M
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…	23,350	$70	$1.6M

Showing 1–10 of 30

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

Southwest Center — 5 of 25 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	7	10	11,170	$90	$4.3M
H2036	Alcohol and/or other drug treatment program, per diem	11	10	2,920	$330	$2M
H2027	Psychoeducational service, per 15 minutes	6	20	410	$170	$1.8M
H0046	Mental health services, not otherwise specified	5	30	350	$100	$1.7M
S5150	Unskilled respite care, not hospice; per 15 minutes	6	10	3,370	$90	$1.1M
H2014	Skills training and development, per 15 minutes	4	50	1,320	$130	$1.1M
T1017	Targeted case management, each 15 minutes	6	60	760	$70	$1.1M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	14	20	240	$240	$808K
H2017	Psychosocial rehabilitation services, per 15 minutes	7	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…	4	370	690	$140	$704.2K

Showing 1–10 of 30

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Logistics, LLC.	UT	Transportation Broker	$0	$299.6M
Red Rock Healthcare, Inc.	UT	Home Health Agency	$0	$27.3M
Virgin River Healthcare, Inc.	UT	In Home Supportive Care Agency	$0	$13.3M
Crimson Heights LLC	UT	Community/Behavioral Health Agency	$0	$7.8M
Southwest Center	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$7.7M
Crimson Heights LLC	UT	Behavior Analyst	$0	$6.8M
Washington County School District	UT	Local Education Agency (LEA)	$0	$6.8M
Red Mesa Home Care	UT	Home Health Agency	$0	$4M
The Learning Center For Families	UT	Developmentally Disabled Services Day Training Agency	$0	$3.9M
Vive Care	UT	Psychiatric Hospital	$0	$3.1M

Southwest Center — Billing Profile & Reimbursement Data

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Southwest Center — 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