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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

South County Psychiatry LLC (NPI 1003454034)

South County Psychiatry LLC is a psychiatry physician provider located in North Kingstown, Rhode Island. This profile covers 0 Medicare and 14 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	South County Psychiatry LLC
Address	420 Scrabbletown Rd Ste A
City	North Kingstown
State	RI
ZIP	02852
Taxonomy	Psychiatry Physician
NPI Enumerated	December 20, 2019

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9480	Intensive outpatient psychiatric services, per diem	3,170	$240	$746.9K
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…	9,830	$60	$589.7K
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…	1,310	$70	$85.2K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	1,310	$40	$57.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	260	$130	$33.4K
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…	590	$40	$25.8K
96139	A technician administers two or more psychological or neuropsychological tests and scores them requiring an additional 30 minutes beyond the initial 30 minutes.	30	$260	$6.5K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	30	$260	$6.5K
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…	60	$90	$5.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	40	$130	$4.8K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

South County Psychiatry LLC — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9480	Intensive outpatient psychiatric services, per diem	1	10	3,170	$240	$745.5K
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…	165	750	330	$70	$92.5K
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…	288	360	280	$90	$86.4K
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…	32	1,730	220	$70	$75.2K
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…	755	2,050	300	$50	$72.3K
96139	A technician administers two or more psychological or neuropsychological tests and scores them requiring an additional 30 minutes beyond the initial 30 minutes.	7	10	70	$270	$63.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	32	160	50	$150	$59.2K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	10	10	40	$320	$51.4K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	50	60	150	$70	$38.3K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	33	200	340	$40	$35.5K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cristina Toba	RI	Psychiatry Physician	$26.4K	$346K
Michael Burgard	RI	Psychiatry Physician	$51.1K	$1.9K
Dylan Hershkowitz	VT	Psychiatry Physician	$51.5K	$0
Beth Dufour	RI	Acute Care Nurse Practitioner	$39.1K	$3.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dominion Diagnostics, LLC	RI	Clinical Medical Laboratory	$4.8M	$249.1M
Perspectives Corporation	RI	Developmentally Disabled Services Day Training Agency	$0	$182.9M
Perspectives Corporation	RI	Developmentally Disabled Services Day Training Agency	$0	$18.1M
Perspectives Corporation	RI	Mental Health Counselor	$0	$13.3M
Perspectives Corporation	RI	Community/Behavioral Health Agency	$0	$13.2M
Perspectives Corporation	RI	Behavior Analyst	$0	$6.6M
The Sensational Child, Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$5.4M
Easter Seals Rhode Island	RI	Early Intervention Provider Agency	$0	$5.2M
Community Care Nurses, Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$1.8M
James Simon	RI	Clinical Social Worker	$0	$1.7M

South County Psychiatry LLC — Billing Profile & Reimbursement Data

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South County Psychiatry LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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