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.

Core Health (NPI 1639693781)

Field	Value
Entity Type	Organization
Organization	Core Health
Address	748 14th Ave
City	Longview
State	WA
ZIP	98632
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 31, 2017

Payer Source	Total Paid
Medicaid	$46M
Medicare	$0

Key Findings

CORE HEALTH is effectively a single-payer Medicaid provider: total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $46M, so all reported program billing on file is Medicaid-driven. This makes Medicaid policy, rates, and utilization trends the primary commercial pressure on the organization’s financials and growth opportunities.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes (H0004, 96165, H0038) account for 66.4% of this provider’s total Medicaid revenue. The three contributors are H0004 ($18.2M; 39.7%), 96165 ($6.7M; 14.5%), and H0038 ($5.6M; 12.2%), which together create a narrow revenue base worth monitoring for reimbursement or authorization changes.

The code mix indicates an operations model built around time-based, community-oriented behavioral health services. H0004 (behavioral health counseling and therapy, per 15 minutes) and H0038 (self-help/peer services, per 15 minutes) are the largest revenue drivers, while group-based cognitive/behavioral codes such as 96165 and 96164 show very large claim volumes, signaling frequent short-interval and group encounters rather than a sole focus on long individual psychotherapy sessions.

For several high-volume codes CORE HEALTH is a dominant statewide player: H0004 ranks #3 of 317 providers in-state (99th percentile; extreme outlier), 96165 ranks #6 of 224 (98th percentile; notably above typical state volume), and H0038 ranks #6 of 125 (96th percentile; notably above typical state volume). Those rankings indicate CORE HEALTH occupies a top-tier position in Washington for peer/self-help and behavioral counseling services specifically, even if other service lines are more typical.

Operational throughput is substantial for time-based codes: H0004 shows 149.5K claims at $122 avg paid/claim, and 96165 shows 46.1K claims at $145 avg paid/claim, reflecting high-frequency delivery and significant dependence on per-15-minute billing. The presence of 96164 with 46.3K claims at $33 avg paid/claim further underscores a group/multi-patient counseling model with high claim counts and varying per-claim reimbursement.

CORE HEALTH also bills conventional psychotherapy and office evaluation codes alongside Medicaid specialty services, showing service breadth beyond peer and skills training programs. For example, 90837 accounts for $3.8M (23.5K claims; listed as typical/unremarkable volume) and 99214 accounts for $2.5M (13.9K claims; typical/unremarkable volume), indicating the organization delivers both longer psychotherapy sessions and E/M encounters at scale.

There is concentration risk tied to a small set of codes: because H0004, 96165, and H0038 together represent 66.4% of Medicaid revenue, changes in coverage, utilization review, or rate-setting for these time-based behavioral codes could disproportionately affect total revenue. The provider’s sizable reliance on short-interval, per-15-minute codes and peer services creates operational sensitivity to utilization management policies targeting those specific service types.

CORE HEALTH has an NPI tenure of 2017-07-31 (~9 years ago), suggesting it is a relatively recent entrant that has scaled quickly within Washington Medicaid behavioral health markets. Rapid growth to extreme or notably above-typical volumes for multiple Medicaid codes implies an intentional focus and successful expansion of community mental health, peer support, and group counseling services over that period.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	149,480	$120	$18.2M
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…	46,140	$150	$6.7M
H0038	Self‑help/peer services, per 15 minutes	34,980	$160	$5.6M
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…	23,510	$160	$3.8M
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…	13,880	$180	$2.5M
H2014	Skills training and development, per 15 minutes	16,040	$110	$1.7M
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…	46,260	$30	$1.5M
H0043	Supported housing, per diem	11,660	$110	$1.3M
H0031	Mental health assessment, by non-physician	6,000	$160	$966.3K
H2015	Comprehensive community support services, per 15 minutes	7,250	$100	$732.6K

Showing 1–10 of 31

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

Core Health — 6 of 25 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0043	Supported housing, per diem	24	140	1,690	$110	$602.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	3	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…	6	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…	141	1,820	480	$60	$379.6K
H2023	Supported employment, per 15 minutes	21	110	1,080	$100	$307.5K
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…	1,333	1,860	610	$40	$295.5K
H2015	Comprehensive community support services, per 15 minutes	40	140	1,820	$20	$283.8K
H2014	Skills training and development, per 15 minutes	2	200	930	$100	$280.7K
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…	33	930	680	$60	$259.2K
H0038	Self‑help/peer services, per 15 minutes	6	130	990	$30	$192.6K

Showing 1–10 of 31

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth	WA	General Acute Care Hospital	$0	$48.2M
Columbia Wellness	WA	Case Management Agency	$0	$32.2M
Child & Adolescent Clinic, Ps	WA	Pediatrics Physician	$0	$21.9M
Cowlitz Indian Tribe	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$16.2M
Eid, Jaber, Jassar, PLLC	WA	Dental Clinic/Center	$0	$15.2M
Peacehealth	WA	Multi-Specialty Clinic/Center	$0	$12.4M
Cowlitz Family Health Center	WA	Federally Qualified Health Center (FQHC)	$0	$11M
Cowlitz Family Health Center	WA	Federally Qualified Health Center (FQHC)	$0	$10.3M
Cowlitz Indian Tribe	WA	General Practice Physician	$0	$10.2M
Arbor Dental	WA	Dentist	$0	$6.3M

Core Health — Billing Profile & Reimbursement Data

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Core Health — 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