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

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

Valley Oaks Health Inc (NPI 1689629990)

Field	Value
Entity Type	Organization
Organization	Valley Oaks Health Inc
Address	415 N 26th Street
City	Lafayette
State	IN
ZIP	47904
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$135.3M
Medicare	$0

Key Findings

VALLEY OAKS HEALTH INC is effectively a single-payer Medicaid provider: it reports no Medicare billing on file while reporting $135.3M in lifetime Medicaid revenue, making Medicaid the dominant and sole reported public payer exposure for the organization. This concentration implies the provider’s financial performance and payer risk are highly tied to Medicaid policy and reimbursement levels in Indiana.

Revenue is heavily concentrated in a small set of service lines: the precomputed top 3 Medicaid codes by revenue account for 87.0% of this provider's total Medicaid revenue, led by H2014 at $104.2M (77.0% of Medicaid revenue), followed by T1016 at $7.9M (5.9%) and 90834 at $5.7M (4.2%). This degree of concentration indicates that programmatic changes affecting H2014 would materially impact overall revenue.

The code mix signals a service model centered on skills training and community-based supports: H2014 (Skills training and development) dominates with 947K claims and an average paid/claim of $110, which together drive the majority of billing. High volumes of case management (T1016, 247.5K claims, $32 avg paid/claim) and non-physician assessment (H0031, 39.1K claims) further reinforce a care-delivery footprint focused on long-duration, team-based behavioral health supports rather than physician-led procedural care.

Despite H2014’s dominance in dollar terms, its in-state competitive position is unexceptional for that code: H2014 ranks #4 of 48 providers in-state (94th percentile) and is described as "typical, unremarkable volume for this code," meaning the absolute volume is large but consistent with peer providers that specialize in skills training. Analysts should interpret the large H2014 dollar share as a specialization signal rather than an outlier in the marketplace for that service.

VALLEY OAKS shows above-typical performance on psychotherapy and evaluation/management codes, indicating substantial outpatient clinical capacity: 90834 has 132K claims and ranks #10 of 584 providers in-state (98th percentile; notably above typical state volume), 90837 and 90832 also rank in the high percentiles (98th and 97th respectively), and 99214 has 66.3K claims and ranks #42 of 2122 providers (98th percentile; notably above typical). These high percentile rankings for both psychotherapy and E/M codes suggest the provider is a major delivery site for ongoing clinical therapy and moderate-complexity medical management within the state.

Several secondary codes further highlight areas of relative strength or distinct services: H0031 (mental health assessment) reports $2.3M and ranks #4 of 40 (92th percentile; notably above typical state volume), 96372 (therapeutic injections) reports 9.6K claims and ranks in the 98th percentile (notably above typical), and 99442 ranks #4 of 133 providers in-state (98th percentile; notably above typical). These high-percentile positions across diverse code types point to a broad service mix that includes assessment, medication-related procedures, and telephonic or remote services.

The provider’s operational scale is reflected both in claim counts and rank breadth: the single largest code alone shows 947K claims (H2014), and multiple codes appear in the top percentiles statewide, indicating a large-volume, multi-service behavioral health operation rather than a small clinic limited to a narrow set of interventions. For payers and competitors, that scale implies significant local capacity for outpatient skills training, psychotherapy, and case management.

VALLEY OAKS has an established presence: the NPI was enumerated on 2006-05-24 (~20 years ago), indicating long-tenure operations in the market. Combined with the concentrated Medicaid revenue profile and high statewide ranks on key therapy and E/M codes, this tenure supports the interpretation of the organization as a longstanding Medicaid behavioral health provider with deep operational experience in community-based services.

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2014	Skills training and development, per 15 minutes	946,990	$110	$104.2M
T1016	Case management, each 15 minutes	247,520	$30	$7.9M
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…	132,010	$40	$5.7M
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…	66,280	$60	$4M
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…	47,620	$80	$3.6M
H0031	Mental health assessment, by non-physician	39,110	$60	$2.3M
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…	43,270	$40	$1.6M
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…	40,940	$40	$1.5M
H0034	Medication training and support, per 15 minutes	62,320	$20	$1.2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	15,850	$70	$1.2M

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Valley Oaks Health Inc — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2014	Skills training and development, per 15 minutes	4	50	75,600	$130	$34.8M
T1016	Case management, each 15 minutes	9	50	8,980	$30	$3.8M
H0004	Behavioral health counseling and therapy, per 15 minutes	38	70	3,960	$130	$1.9M
T2022	Case management, per month	74	100	710	$180	$1.1M
H0031	Mental health assessment, by non-physician	4	40	6,070	$70	$724.3K
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…	10	580	710	$60	$582.9K
H0034	Medication training and support, per 15 minutes	3	30	7,890	$20	$529.8K
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…	42	2,120	870	$60	$450.6K
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…	14	690	1,070	$80	$422.3K
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…	86	2,380	920	$50	$376.8K

Showing 1–10 of 34

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wabash Center, Inc.	IN	Developmentally Disabled Services Day Training Agency	$0	$34.2M
Community Ventures In Living, Ltd.	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$34M
Riggs Community Health Center Inc	IN	Federally Qualified Health Center (FQHC)	$0	$22.2M
Franciscan Health Lafayette	IN	Land Ambulance	$1.4M	$8.8M
Help At Home, LLC	IN	Nursing Care Agency	$0	$8.3M
Lafayette School Corporation	IN	Local Education Agency (LEA)	$0	$5.3M
Lafayette Pediatric Dentistry & Orthodontics	IN	Dentist	$0	$4.1M
Rodney Kusumi	IN	Ophthalmology Physician	$2M	$0
Arnett Clinic, LLC	IN	Clinical Medical Laboratory	$330.3K	$1.1M
Matthew Orton	IN	Radiation Oncology Physician	$782.4K	$0

Valley Oaks Health Inc — 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