Loading...
NPI 1356357115 · Provo, UT · Community/Behavioral Health Agency
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Wasatch Behavioral Health Special Service District is a community/behavioral health agency provider located in Provo, Utah. This profile covers 0 Medicare and 49 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Wasatch Behavioral Health Special Service District |
| Address | 750 N Freedom Blvd |
| City | Provo |
| State | UT |
| ZIP | 84601 |
| Taxonomy | Community/Behavioral Health Agency |
| NPI Enumerated | August 1, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $178.1M |
| Medicare | $0 |
WASATCH BEHAVIORAL HEALTH SPECIAL SERVICE DISTRICT is effectively a single-payer Medicaid provider: there is no Medicare billing on file and its lifetime Medicaid revenue is $178.1M. The absence of Medicare activity indicates the organization’s services and reimbursement base are concentrated in Medicaid populations rather than fee-for-service Medicare beneficiaries.
Revenue is highly concentrated in a small set of service lines: the precomputed top three Medicaid codes (90837, T1017, H0046) together account for 37.4% of the provider’s total Medicaid revenue. In particular, 90837 alone represents 20.0% of Medicaid revenue (269.4K claims, $33.9M), showing a major reliance on long-session individual psychotherapy.
The provider’s code mix points to a broad, community-focused behavioral health operation that emphasizes psychotherapy, targeted case management, and unspecified mental health services. High-volume codes include 90837 (long psychotherapy), T1017 (targeted case management, 255.7K claims, $16.9M), H0046 (mental health services, 136.2K claims, $12.7M) and multiple per-15-minute rehabilitative and community support codes (H2014, H2027, H2017), indicating both outpatient therapy and intensive community-based supports.
WASATCH is a dominant statewide player for several key behavioral health codes: it ranks #1 of 372 providers in-state for 90837 (100th percentile, extreme outlier) and holds top or near-top ranks for many other high-revenue codes (for example, T1017 ranks #2 of 61, 98th percentile; H0046 ranks #2 of 30, 97th percentile). These rank/percentile signals identify the provider as an extreme outlier in Utah for volume on core psychotherapy, case management, and psychoeducational services.
Beyond the top three, the provider reports consistently elevated volumes across an array of specialty behavioral health services — group therapy (90853, 117.3K claims, $6.2M), psychosocial rehabilitation (H2017, 113K claims, $8M), therapeutic behavioral services (H2019, 90.5K claims, $7.2M), and psychological testing (96130/96131). Many of these codes are in the 97th–100th percentiles in-state and are described as extreme outliers, indicating breadth as well as depth in behavioral health offerings.
Service mix includes higher-acuity and institutional-style reimbursement lines as well: psychiatric health facility per diem H2013 accounts for $6.3M (14.3K claims) and short-term residential H0018 generates $4.5M (27.6K claims). These per-diem lines are not flagged as extreme outliers (H2013 ranks #2 of 11 at the 90th percentile; H0018 ranks in the mid-to-high state distribution), suggesting the organization operates both high-volume outpatient/community services and a measurable inpatient/residential component.
There are notable code-level exceptions where the provider is uniquely dominant or unusually large compared with peers: codes ranked #1 in-state (90837, H2027, T1001, 90792, 96130/96131, 90847, S5150, 90846) are repeatedly labeled extreme outliers or notably above typical state volume. This pattern implies that for strategic contracting or network adequacy discussions, payers should treat WASATCH as a key regional source for those specific services.
The provider’s NPI tenure (enumerated 2006-08-01, ~20 years ago) indicates long-standing operation in the market, which — together with persistent high volumes across outpatient psychotherapy, case management, testing, and community supports — supports a profile of an established, large-scale community/behavioral health agency focused on Medicaid populations. Analysts evaluating competitive standing should view WASATCH as a long-tenured, high-capacity Medicaid behavioral health provider with concentrated revenue exposure to a handful of high-volume therapy and case-management codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
49 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… | 269,420 | $130 | $33.9M |
| T1017 | Targeted case management, each 15 minutes | 255,710 | $70 | $16.9M |
| H0046 | Mental health services, not otherwise specified | 136,230 | $90 | $12.7M |
| H2014 | Skills training and development, per 15 minutes | 65,420 | $140 | $9.3M |
| H2027 | Psychoeducational service, per 15 minutes | 75,490 | $120 | $8.9M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 112,960 | $70 | $8M |
| 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… | 75,620 | $110 | $7.9M |
| T1001 | Nursing assessment / evaluation | 126,890 | $60 | $7.6M |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 37,170 | $200 | $7.4M |
| H2019 | Therapeutic behavioral services, per 15 minutes | 90,500 | $80 | $7.2M |
Showing 1–10 of 49
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
49 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 | 5 | 30 | 1,340 | $330 | $5.8M |
| H0012 | Behavioral health day treatment, per hour | 2 | 10 | 3,030 | $330 | $5.4M |
| H2016 | Comprehensive community support services, per diem | 3 | 10 | 11,170 | $90 | $4.3M |
| H2013 | Psychiatric health facility service, per diem | 2 | 10 | 1,960 | $520 | $3.5M |
| H2027 | Psychoeducational service, per 15 minutes | 1 | 20 | 410 | $170 | $1.8M |
| H0046 | Mental health services, not otherwise specified | 2 | 30 | 350 | $100 | $1.7M |
| T1016 | Case management, each 15 minutes | 11 | 20 | 3,150 | $70 | $1.6M |
| S9485 | Crisis intervention mental health services, per diem | 1 | 10 | 3,160 | $550 | $1.5M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 14 | 20 | 42,000 | $10 | $1.2M |
| S5150 | Unskilled respite care, not hospice; per 15 minutes | 1 | 10 | 3,370 | $90 | $1.1M |
Showing 1–10 of 49
Other providers in the same ZIP code as Wasatch Behavioral Health Special Service District, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Provo City Corporation | UT | Land Ambulance | $161.1K | $3.7M |
| Utah County Government | UT | Public Health or Welfare Agency | $141K | $3M |
| Utah County Department Of Drug And Alcohol Prevention And Treatment | UT | Substance Use Disorder Rehabilitation Clinic/Center | $0 | $2.5M |
| Country View Assisted Living LLC | UT | Assisted Living Facility | $0 | $2.3M |
| Kevin Markham | UT | Pediatric Dentistry | $0 | $977.4K |
| Bryce Bott | UT | Pediatric Dentistry | $0 | $794.2K |
| Ach Provo, LLC | UT | In Home Supportive Care Agency | $0 | $761.3K |
| Valley Obstetrics And Gynecology, PC | UT | Obstetrics & Gynecology Physician | $0 | $452.1K |
| Trace Lund | UT | Pediatric Dentistry | $0 | $450.4K |
| Ardu LLC | UT | Substance Abuse Rehabilitation Facility | $0 | $436K |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.