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.

The Valley Alcohol Council (NPI 1548306210)

Field	Value
Entity Type	Organization
Organization	The Valley Alcohol Council
Address	315 N 2nd St
City	Yakima
State	WA
ZIP	98901
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	January 30, 2007

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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
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…	30,440	$60	$1.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	13,130	$60	$735.4K
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…	30,290	$20	$575.6K
96153	N/A	11,300	$30	$338.9K
H0001	Alcohol and/or drug assessment	580	$90	$49.8K
H0046	Mental health services, not otherwise specified	860	$30	$23.3K
T1016	Case management, each 15 minutes	1,310	$10	$11.8K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	920	$10	$11K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	6,780	$1	$6.8K
H0003	Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs	2,650	$1	$5.3K

Showing 1–10 of 12

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

The Valley Alcohol Council — 1 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	43	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…	13	220	2,880	$50	$431K
H0038	Self‑help/peer services, per 15 minutes	119	130	990	$30	$192.6K
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…	14	230	3,070	$20	$135.6K
96153	N/A	30	210	2,910	$20	$105.2K
H0001	Alcohol and/or drug assessment	59	210	220	$150	$104K
T1017	Targeted case management, each 15 minutes	71	80	410	$30	$74.4K
H0003	Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs	8	30	250	$20	$54.6K
H0046	Mental health services, not otherwise specified	102	210	800	$10	$30.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	74	220	470	$10	$18.7K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as The Valley Alcohol Council, 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 Council On Alcoholism	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$38.6M
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
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

The Valley Alcohol Council — Billing Profile & Reimbursement Data

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The Valley Alcohol Council — Billing Profile & Reimbursement Data

Sign up for The Valley Alcohol Council — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References