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 1548212640)

Field	Value
Entity Type	Organization
Organization	Southwest Center
Address	474 W 200 N
City	St George
State	UT
ZIP	84770
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	May 17, 2006

Payer Source	Total Paid
Medicaid	$7.7M
Medicare	$0

Key Findings

SOUTHWEST CENTER is effectively a Medicaid-focused behavioral health provider: it has no Medicare billing on file and reports $7.7M in total Medicaid revenue, making its payer footprint single-payer in practice rather than split between Medicare and Medicaid. This concentration in Medicaid should be treated as the primary lens for understanding its business operations and revenue risk.

Revenue concentration is high: the top three Medicaid codes (90853, 90837, H2019) account for 65.3% of this provider’s total Medicaid revenue, indicating that a relatively small set of psychotherapy and behavioral-service lines drive the majority of receipts. That concentration suggests financial sensitivity to changes in reimbursement or utilization for those specific services.

The code mix shows an SUD-focused outpatient and group-therapy operating model: 90853 (group psychotherapy) is the single largest line at $2.7M (34.8% of this provider's total Medicaid revenue) and 90837 (long psychotherapy) contributes $1.4M (18.6%). Combined with H2019 (therapeutic behavioral services, $922.1K; 11.9%), the portfolio points to a program that relies heavily on group psychotherapy and intensive behavioral interventions consistent with a Substance Use Disorder Rehabilitation Clinic/Center taxonomy.

Competitive standing in-state is uneven but strong for group therapy: 90853 ranks #7 of 150 providers in Utah (96th percentile) and is labeled as notably above typical state volume, making SOUTHWEST CENTER a major in-state provider for group psychotherapy. By contrast, other high-revenue codes such as 90837 ($1.4M, 18.6%) and H2019 ($922.1K, 11.9%) are described as typical or unremarkable for volume despite being high-revenue for this provider, so dominance is concentrated mainly in the group-therapy line.

Several high-revenue claims reflect higher-intensity services and per-diem SUD programming: H2036 (alcohol and/or other drug treatment program, per diem) generates $826.6K (10.7% of Medicaid revenue) and 90791 (psychiatric evaluation) generates $732.6K (9.5%), indicating the organization bills both day-rate residential/partial-hospitalization style SUD services and diagnostic evaluation work alongside psychotherapy. These entries reinforce that revenue is not solely from routine office visits but from programmatic SUD treatment modalities.

Operational footprint shows scale in utilization-based services: the largest lines have high claim volumes (90853: 34.1K claims; 90837: 10.3K claims; H2019: 17.7K claims), indicating throughput-oriented delivery (many group and time-based sessions) rather than a small-panel, high-dollar-per-encounter model. This operational profile aligns with a clinic delivering frequent, shorter-duration services and group sessions to Medicaid populations.

Tenure and market presence are established: the provider’s NPI was enumerated on 2006-05-17 (~20 years ago), suggesting a long-standing presence in the local market that may support referral relationships and program continuity. That longevity, combined with a top-10 statewide rank on 90853, supports the view of an entrenched regional provider for group-based behavioral health services.

There are noteworthy distributional nuances and potential gaps: while several codes rank in the upper percentiles for volume (90853 at the 96th percentile; 90837 and 90791 at high state percentiles described as typical), other Medicaid codes account for much smaller shares of revenue (for example, 99213 contributes $13.6K or 0.2% of Medicaid revenue). Also, H0031 is listed as #13 of 14 (8th percentile) and characterized in the data as typical, which highlights areas where the provider does not participate heavily compared with peers and could indicate limited breadth in non-SUD specialty services.

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
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…	34,100	$80	$2.7M
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…	10,290	$140	$1.4M
H2019	Therapeutic behavioral services, per 15 minutes	17,730	$50	$922.1K
H2036	Alcohol and/or other drug treatment program, per diem	8,030	$100	$826.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	2,330	$310	$732.6K
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…	3,570	$110	$378.2K
H0006	Alcohol and/or drug services; case management	6,540	$50	$300.7K
H2017	Psychosocial rehabilitation services, per 15 minutes	7,020	$30	$196.7K
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…	2,770	$60	$155.3K
90849	In this procedure, the provider performs a psychotherapy session with a group of patients’ families.	1,500	$50	$79.3K

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

Southwest Center — 1 of 12 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
H2036	Alcohol and/or other drug treatment program, per diem	5	10	2,920	$330	$2M
H2017	Psychosocial rehabilitation services, per 15 minutes	20	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…	32	370	690	$140	$704.2K
H2019	Therapeutic behavioral services, per 15 minutes	11	90	560	$80	$649.9K
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…	7	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…	18	110	270	$120	$439.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	12	140	160	$220	$374.1K
H0006	Alcohol and/or drug services; case management	11	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…	17	90	270	$70	$200.4K
H0031	Mental health assessment, by non-physician	13	10	540	$120	$154K

Showing 1–10 of 12

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
Southwest Center	UT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$58.3M
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
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