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.

Valley Behavioral Health Incorporated (NPI 1932166980)

Field	Value
Entity Type	Organization
Organization	Valley Behavioral Health Incorporated
Address	3725 W 4100 S Ste 105
City	West Valley City
State	UT
ZIP	84120
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	April 26, 2006

Payer Source	Total Paid
Medicaid	$293.3M
Medicare	$0

Key Findings

VALLEY BEHAVIORAL HEALTH INCORPORATED is effectively a single-payer Medicaid operator: there is no Medicare billing on file while lifetime Medicaid revenue totals $293.3M. The absence of Medicare activity combined with substantial Medicaid receipts indicates the organization’s clinical and business footprint is concentrated in state Medicaid programs rather than fee-for-service Medicare markets.

Revenue is highly concentrated within a few service lines: the top 3 Medicaid codes by revenue (H2016, 90837, H2017) account for 35.3% of the provider’s total Medicaid revenue. Specifically, H2016 generated $39.5M (13.7% of Medicaid revenue), 90837 generated $36.9M (12.8%), and H2017 generated $25.5M (8.8%), signaling that a small set of behavioral health services drives a large share of revenue.

The mix of high-revenue codes points to an integrated behavioral health operation that spans community support, intensive outpatient psychotherapy, and structured rehabilitation: H2016 (Comprehensive community support services), H2017 (Psychosocial rehabilitation), and 90837 (long psychotherapy sessions) are dominant revenue drivers. This combination suggests coordinated programs offering both psychotherapy and long-duration community-based support rather than a narrow clinic that only bills short outpatient visits.

State-level competitive standing is dominant for many core behavioral services: H2016 ranks #1 of 14 providers in-state at the 100th percentile and is labeled an extreme outlier; H2017 also ranks #1 of 94 (100th percentile, extreme outlier); T1017 and H0018 similarly rank #1 of their peer sets (100th percentile, extreme outlier). Those #1 ranks and extreme outlier labels indicate the provider is a market leader in Utah for several Medicaid behavioral health service lines.

High-volume psychotherapy and outpatient evaluation activity is evident across both clinical and generalist E&M codes: 90837 reports 217.3K claims and $36.9M revenue (12.8% of Medicaid revenue) and 99214 reports 99K claims and $12.6M revenue (4.3% of Medicaid revenue) with 99214 ranked #3 of 1340 providers (100th percentile). These volumes show the provider delivers very large quantities of face-to-face psychotherapy and moderate-complexity outpatient visits relative to in-state peers.

The provider operates a sizable testing and monitoring practice alongside therapy services, reflected by very high volumes for drug testing codes: 80307 shows 172.1K claims and $7.9M revenue (2.7% of Medicaid revenue) ranked #2 of 74 providers (99th percentile), and G0481 shows 100.8K claims and $5.0M revenue (1.7% of Medicaid revenue) ranked #1 of 15 providers (100th percentile, extreme outlier). These patterns suggest integrated substance-use monitoring and diagnostic services supporting behavioral health programs.

Evidence of capacity for higher-acuity and residential services is present in the code mix: H0018 (short-term residential non-hospital) produced $23M (8.0% of Medicaid revenue) and ranks #1 of 30 providers (100th percentile, extreme outlier), while H2013 (psychiatric health facility per diem) generated $12.9M (4.5% of Medicaid revenue) and ranks #1 of 11 providers (100th percentile). The presence of multiple high-ranked per-diem codes indicates the organization bills significant residential and facility-level behavioral health care in addition to outpatient services.

The provider’s NPI tenure—enumerated 2006-04-26 (~20 years ago)—combined with the scale and concentration of Medicaid billing suggests an established, Medicaid-focused behavioral health system. Long tenure plus dominant state rankings across many codes point to a sustained market position in Utah’s behavioral health delivery and Medicaid contracting landscape.

Medicaid: Complete Services Breakdown

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

85 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	387,160	$100	$39.5M
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…	217,280	$170	$36.9M
H2017	Psychosocial rehabilitation services, per 15 minutes	273,770	$90	$25.5M
T1017	Targeted case management, each 15 minutes	340,180	$70	$24.5M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	168,060	$140	$23M
H2019	Therapeutic behavioral services, per 15 minutes	145,990	$140	$20.9M
H2013	Psychiatric health facility service, per diem	30,220	$430	$12.9M
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…	98,980	$130	$12.6M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	36,730	$340	$12.3M
H2014	Skills training and development, per 15 minutes	89,570	$110	$9.5M

Showing 1–10 of 85

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

Valley Behavioral Health Incorporated — 20 of 25 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

85 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	21	30	7,130	$260	$8.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	1	30	1,340	$330	$5.8M
H2016	Comprehensive community support services, per diem	1	10	11,170	$90	$4.3M
H2013	Psychiatric health facility service, per diem	1	10	1,960	$520	$3.5M
H0040	Assertive community treatment program, per diem	2	10	1,500	$1,050	$2.5M
H2036	Alcohol and/or other drug treatment program, per diem	2	10	2,920	$330	$2M
H2027	Psychoeducational service, per 15 minutes	4	20	410	$170	$1.8M
H0046	Mental health services, not otherwise specified	8	30	350	$100	$1.7M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	21	30	2,270	$140	$1.7M
S5150	Unskilled respite care, not hospice; per 15 minutes	2	10	3,370	$90	$1.1M

Showing 1–10 of 85

Related Providers

Other providers that share a Tax Identification Number (TIN) with Valley Behavioral Health Incorporated, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jordan Valley Medical Center LP	UT	General Acute Care Hospital	$0	$15.6M
Foundations Lc	UT	Mental Illness Community Based Residential Treatment Facility	$0	$2.8M
Tyler Reading	UT	Pediatric Dentistry	$0	$2.1M
Dentistry For Children West Valley PC	UT	Dental Clinic/Center	$0	$1.9M
Kadin Wilson	UT	Pediatric Dentistry	$0	$1.7M
Ari Hobfoll	UT	Pediatric Dentistry	$0	$1.3M
Community Health Centers, Inc.	UT	Federally Qualified Health Center (FQHC)	$0	$890.8K
Wasatch Front Surgery Center LLC	UT	Ambulatory Surgical Clinic/Center	$414.9K	$1.9K
Valley Medical Equipment Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$365.6K
Timothy Grange	UT	Physical Medicine & Rehabilitation Physician	$61.2K	$200K

Valley Behavioral Health Incorporated — Billing Profile & Reimbursement Data

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Valley Behavioral Health Incorporated — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References