Valley Medical Facilities, INC.

Valley Medical Facilities, INC. was paid $4.94M by Medicaid between Oct 2019 and Dec 2024, across 2 billing codes. Its largest line is T1017, case management, billed per 15 minutes — 95% of everything it billed.

33Billing provider infoVALLEY MEDICAL FACILITIES, INC.
SEWICKLEY, PA 15143

33aNPI1316063068assigned 03/22/2007

33bProvider typeCase Management Agency

28Total paid$4.94M

24GClaims36,563

24DCodes billed2

24AFirst – last monthOct 2019 – Dec 2024

Compared with peers

Next to other Case Management Agency providers in Pennsylvania

Rank by total paid#76 of 206

Median peer was paid$2.13M

This provider vs. median2.3×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration95% of spending on code T1017 with only 2 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2019	31	$3K
2020	2,074	$190K
2021	9,077	$1.05M
2022	9,009	$1.19M
2023	8,978	$1.37M
2024incomplete	7,394	$1.14M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1017	Case management, billed per 15 minutesTargeted case management, each 15 minutes	95%	34,658	11,525	$4.68M
H0038	Self-help/peer services, per 15 minutes	5.3%	1,905	778	$262K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialRANDALL, BRYAN (VICE PRESIDENT CFO)