Clinic
Southwest Colorado Mental Health Center, INC
Southwest Colorado Mental Health Center, INC was paid $4.27M by Medicaid between Jan 2018 and Feb 2024, across 22 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 42% of everything it billed.
33Billing provider infoSOUTHWEST COLORADO MENTAL HEALTH CENTER, INC
DURANGO, CO 81301
DURANGO, CO 81301
33aNPI1316374283assigned 10/08/2013
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$4.27M
24GClaims28,056
24DCodes billed22
24AFirst – last monthJan 2018 – Feb 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Colorado
Rank by total paid#62 of 197
Median peer was paid$1.11M
This provider vs. median3.9×
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.
Entity ProliferationAuthorized official BURKE, SHELLY controls 18+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2018 | 2,655 | $363K | |
| 2019 | 5,171 | $699K | |
| 2020 | 4,505 | $692K | |
| 2021 | 5,301 | $838K | |
| 2022 | 4,424 | $814K | |
| 2023 | 5,406 | $766K | |
| 2024incomplete | 594 | $95K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 42% | 8,633 | 7,371 | $1.77M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 37% | 7,431 | 6,477 | $1.56M |
| D0999 | Unspecified diagnostic procedure, by report | 8.8% | 1,038 | 974 | $374K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 5.0% | 1,688 | 1,029 | $213K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.6% | 547 | 477 | $111K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 2.0% | 352 | 330 | $84K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.2% | 246 | 222 | $52K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 104 | 88 | $21K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 407 | 378 | $21K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 1,742 | 1,138 | $20K |
| 99406 | <1% | 533 | 453 | $15K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 58 | 54 | $12K |
10 more codes
| 90686 | <1% | 382 | $3K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 14 | $3K |
| H0049 | Alcohol and/or drug screening | <1% | 1,830 | $2K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 1,145 | $2K |
| D1110 | Prophylaxis - adult | <1% | 616 | $1K |
| 36415 | Collection of venous blood by venipuncture | <1% | 708 | $904.77 |
| D0274 | Bitewings - four radiographic images | <1% | 112 | $108.00 |
| 96127 | 0% | 222 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 234 | $0.00 |
| 83037 | 0% | 14 | $0.00 |
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 officialBURKE, SHELLY (CHIEF EXECUTIVE OFFICER)
Parent organizationSOUTHWEST COLORADO MENTAL HEALTH CENTER, INC.
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.