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

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

Sequoia Mental Health Services Inc (NPI 1730167982)

Field	Value
Entity Type	Organization
Organization	Sequoia Mental Health Services Inc
Address	4585 Sw 185th Ave
City	Aloha
State	OR
ZIP	97007
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 6, 2006

Payer Source	Total Paid
Medicaid	$27.6M
Medicare	$0

Key Findings

SEQUOIA MENTAL HEALTH SERVICES INC is effectively single‑payer in scale: there is no Medicare billing on file while total Medicaid revenue is $27.6M, indicating the organization’s operations and revenue are concentrated in the Medicaid program rather than split across Medicare and Medicaid. This payer concentration makes state Medicaid policy and contracting key to the provider’s financial outlook.

Revenue is highly concentrated in a very small set of service lines: the precomputed top three Medicaid codes account for 80.6% of the provider’s Medicaid revenue, driven by T1020 ($13M, 47.3%), H0004 ($7.5M, 27.1%), and T1016 ($1.7M, 6.2%). That concentration implies most of the business depends on a few high‑volume service categories rather than a broad, diversified mix of billings.

The code mix and volumes indicate a community behavioral health model that combines per‑diem personal care with very high volume counseling and substantial case management. Specifically, T1020 shows 2.3K claims for per‑diem personal care services, H0004 shows 54.1K claims for behavioral health counseling and therapy, and T1016 shows 16.4K claims for case management — a blend consistent with integrated community‑based behavioral health and support services.

State competitive standing is mixed by service line: the provider is a major statewide performer in counseling and case management (H0004 ranks #10 of 265 providers in-state, 97th percentile; T1016 ranks #5 of 206, 98th percentile), while its largest revenue code T1020 is more typical in-state (ranks #17 of 44, 63th percentile; labeled typical, unremarkable volume). This suggests SEQUOIA is a leading provider for high‑frequency counseling and case management but not dominant among in‑state per‑diem personal care providers.

There are specific statistical outliers within the billing mix that warrant attention for capacity and service focus: code 99443 appears as an extreme outlier (3.7K claims, $337.7K revenue; ranks #3 of 116 providers in-state, 98th percentile, described as "extreme outlier, far above typical state volume"). High relative volume on an otherwise uncommon code may reflect specialized telehealth or remote visit activity or a coding focus that differs from most peers.

Clinical intake and planning services are also prominent, indicating a robust assessment and care‑coordination capability: H0031 (mental health assessment by non‑physician) has 2.7K claims and $721.9K revenue, ranking #5 of 78 (95th percentile), and H0032 (service plan development) has 2.6K claims and $359.1K revenue, ranking #10 of 188 (95th percentile). These high ranks for assessment and plan development support the interpretation of an organization oriented to ongoing outpatient care and coordination.

The provider also delivers measurable outpatient medical evaluation and management alongside behavioral services: 99214 appears 12.4K claims and $1.1M revenue (3.8% of Medicaid revenue), ranking #122 of 1503 in-state (92th percentile), and 99213 shows 2.7K claims and $211.6K revenue. These E/M volumes suggest embedded clinical encounters and medical oversight that complement the behavioral health and case management services.

SEQUOIA’s NPI was enumerated 2006-01-06 (~20 years ago), indicating a long tenure in the market. Combined with concentrated Medicaid revenue and leading ranks on multiple behavioral health and case management codes, this longevity suggests entrenched operational capacity and established referral or contract relationships within Oregon’s Medicaid system.

Medicaid: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	2,260	$5,770	$13M
H0004	Behavioral health counseling and therapy, per 15 minutes	54,090	$140	$7.5M
T1016	Case management, each 15 minutes	16,390	$100	$1.7M
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…	12,360	$90	$1.1M
H2018	Psychosocial rehabilitation services, per diem	1,350	$540	$729.5K
H2014	Skills training and development, per 15 minutes	9,300	$80	$725K
H0031	Mental health assessment, by non-physician	2,720	$270	$721.9K
H0032	Mental health service plan development by non-physician	2,620	$140	$359.1K
99443	N/A	3,710	$90	$337.7K
H0005	Alcohol and/or drug services; group counseling by a clinician	10,450	$30	$324K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Sequoia Mental Health Services Inc — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	17	40	1,330	$1,170	$6.4M
H2018	Psychosocial rehabilitation services, per diem	7	10	1,350	$180	$2M
H0046	Mental health services, not otherwise specified	10	10	2,340	$90	$1.5M
H0005	Alcohol and/or drug services; group counseling by a clinician	51	180	3,250	$40	$783.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	10	270	1,660	$90	$681K
H0038	Self‑help/peer services, per 15 minutes	60	150	1,030	$80	$417.2K
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…	630	1,380	540	$140	$363.3K
H2014	Skills training and development, per 15 minutes	19	120	1,010	$40	$323.2K
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…	122	1,500	650	$70	$312.4K
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…	385	1,590	590	$50	$236.5K

Showing 1–10 of 30

Nearby Providers

Other providers in the same ZIP code as Sequoia Mental Health Services Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scholls Family Care	OR	Family Medicine Physician	$0	$1.4M
Walgreen Co	OR	Pharmacy	$95.9K	$0
David Larson	OR	Internal Medicine Physician	$73.4K	$7.9K
Nayana Kode	OR	Physical Therapist	$49.5K	$0
Amy Friday	OR	Clinical Neuropsychologist	$23K	$0
Marilyn Stephens	OR	Clinical Social Worker	$13.4K	$0
Sonia Dumas	OR	Family Nurse Practitioner	$5.3K	$0
Randolph Smith	OR	Speech-Language Pathologist	$2.7K	$0

Sequoia Mental Health Services Inc — Billing Profile & Reimbursement Data

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Sequoia Mental Health Services 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