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

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

Yakima Valley Council On Alcoholism (NPI 1306050372)

Field	Value
Entity Type	Organization
Organization	Yakima Valley Council On Alcoholism
Address	120 S. 3rd Street
City	Yakima
State	WA
ZIP	98901
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	May 9, 2007

Payer Source	Total Paid
Medicaid	$38.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $38.6M, indicating the organization’s entire reported billing footprint in the available data is concentrated in Medicaid. That concentration means any financial or policy changes at the state Medicaid level would materially affect the provider’s reimbursement stream.

Revenue is highly concentrated in a very small set of services: the top three Medicaid codes (H0018, H0019, H2036) together account for 91.7% of the provider’s Medicaid revenue. Individually those codes are H0018 at $25.1M (65.0%), H0019 at $8.6M (22.2%), and H2036 at $1.8M (4.6%), showing the business is overwhelmingly dependent on a narrow set of per‑diem residential and treatment program payments.

The code mix points to a bed‑based, residential substance use disorder model as the core business. H0018 (short‑term residential, per diem) and H0019 (long‑term residential, per diem) are the top revenue drivers and H2036 (Alcohol and/or other drug treatment program, per diem) is also material; together these per‑diem residential/treatment codes imply the organization operates substantial non‑hospital residential treatment capacity and bills primarily on a per‑day basis rather than through high‑value episodic professional services.

There is a marked mismatch between claim volumes and revenue for some services: H2036 shows 135.6K claims but only $1.8M in revenue with a $13 avg paid/claim, which suggests very high utilization of a low per‑unit reimbursed program. By contrast H0018 has 94.3K claims at $266 avg paid/claim and generates $25.1M, indicating that per‑diem reimbursement levels for H0018 drive most dollars despite somewhat lower claim counts than H2036.

Competitive standing within Washington state is unusually strong for specific per‑diem codes. The provider ranks #2 of 59 for H0018 (98th percentile; extreme outlier, far above typical state volume for this code) and ranks #1 of 68 for H2036 (100th percentile; extreme outlier, far above typical state volume for this code), signaling dominance in those service lines; by comparison H0019 ranks #10 of 54 (83th percentile; typical, unremarkable volume for this code), indicating a more ordinary position among long‑term residential providers.

Counseling, group, and assessment services appear as secondary revenue lines: 96165 accounts for $1.2M (3.2% of Medicaid revenue) with 24.7K claims, while H0004 and 96164 each contribute around $495.8K (1.3%) and $470.8K (1.2%) respectively. These volumes show the provider does bill for therapy and behavioral health counseling, but those codes are small relative to the predominant residential per‑diem business.

The provider has an established presence in the market with an NPI enumerated on 2007-05-09 (~19 years ago), which supports the interpretation that the organization’s residential treatment operations are long‑standing rather than newly scaled. Longevity combined with the extreme outlier rankings for key per‑diem codes suggests sustained specialization in Medicaid‑funded residential SUD services.

Given the Medicaid concentration and the dominance of per‑diem residential codes, the provider’s financial and operational exposure is concentrated on state reimbursement rates and program definitions for H0018, H0019, and H2036. Any policy changes affecting per‑diem payments, eligibility for residential placement, or program configuration in Washington Medicaid would disproportionately affect this provider’s revenue base.

Medicaid: Complete Services Breakdown

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

26 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	94,330	$270	$25.1M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	35,230	$240	$8.6M
H2036	Alcohol and/or other drug treatment program, per diem	135,640	$10	$1.8M
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	24,670	$50	$1.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	7,750	$60	$495.8K
96164	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	24,780	$20	$470.8K
96153	N/A	12,990	$20	$285.7K
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…	1,340	$130	$177.1K
H0001	Alcohol and/or drug assessment	850	$140	$118.2K
H0038	Self‑help/peer services, per 15 minutes	1,480	$70	$95.9K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Yakima Valley Council On Alcoholism — 2 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

26 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	2	60	8,670	$280	$4.9M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	10	50	4,000	$60	$1.5M
H2020	Therapeutic behavioral services, per diem	5	10	930	$480	$1.1M
H0043	Supported housing, per diem	62	140	1,690	$110	$602.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	76	320	2,080	$60	$495.5K
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	19	220	2,880	$50	$431K
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…	1,337	1,820	480	$60	$379.6K
H2036	Alcohol and/or other drug treatment program, per diem	1	70	4,930	$20	$344.7K
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…	1,274	1,860	610	$40	$295.5K
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…	338	930	680	$60	$259.2K

Showing 1–10 of 26

Nearby Providers

Other providers in the same ZIP code as Yakima Valley Council On Alcoholism, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sundown M Ranch	WA	Substance Abuse Rehabilitation Facility	$0	$39.8M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$22.3M
Yakima Neighborhood Health Services	WA	Federally Qualified Health Center (FQHC)	$0	$15.2M
Yakima Neighborhood Health Services	WA	Federally Qualified Health Center (FQHC)	$0	$14.2M
Yakima Neighborhood Health Services	WA	Federally Qualified Health Center (FQHC)	$0	$12.6M
Barth And Associates	WA	Case Management Agency	$0	$4.2M
The Valley Alcohol Council	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.6M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$3.4M
Evan Shute	WA	Physical Therapist	$122.5K	$0
Amelia Rutter	WA	Family Nurse Practitioner	$6.2K	$1.4K

Yakima Valley Council On Alcoholism — Billing Profile & Reimbursement Data

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Yakima Valley Council On Alcoholism — 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