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

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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 Bay Mental Health Center, Inc. (NPI 1023096864)

Field	Value
Entity Type	Organization
Organization	South Bay Mental Health Center, Inc.
Address	1115 West Chestnut Street
City	Brockton
State	MA
ZIP	02301
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	January 3, 2006

Payer Source	Total Paid
Medicaid	$112M
Medicare	$0

Key Findings

SOUTH BAY MENTAL HEALTH CENTER, INC. is effectively a single‑payer Medicaid provider with no Medicare billing on file and $112M in lifetime Medicaid revenue; this makes Medicaid the exclusive documented public payer relationship and indicates the organization’s clinical and billing activity is concentrated within state Medicaid programs rather than Medicare.

Revenue concentration is high: the top 3 Medicaid codes (90834, H2019, T1027) together account for 80.4% of this provider’s total Medicaid revenue. This indicates a narrow set of intensive behavioral health service lines—individual psychotherapy, therapeutic behavioral services, and family training/counseling—drive the vast majority of reimbursement.

The code-level mix signals an outpatient community mental health operational model focused on psychotherapy and intensive, time-based pediatric/behavioral interventions: 90834 (38–52 minute psychotherapy) is the single largest driver at $45.3M (40.4% of Medicaid revenue), while H2019 (therapeutic behavioral services, per 15 minutes) and T1027 (family training and counseling, per 15 minutes) contribute $29.6M (26.5%) and $15.1M (13.5%), respectively. Together these suggest large volumes of recurring, time-based visits and family-based services, consistent with community mental health and intensive outpatient/behavioral programs.

The provider is a dominant in-state volume leader on multiple core codes: 90834 ranks #1 of 1617 providers in-state (100th percentile, labeled an extreme outlier), H2019 ranks #2 of 294 providers in-state (100th percentile, extreme outlier), and T1027 ranks #4 of 131 providers (98th percentile, extreme outlier). These rankings indicate market leadership in Massachusetts for high-volume psychotherapy and therapeutic behavioral services relative to peers.

Beyond the top three, SOUTH BAY still shows substantially above-typical volumes for several other behavioral health codes: H2012, 90882, 90887, 90847, 90791 and 90832 all rank in the high percentiles (98–100th) and are described as extreme outliers or notably above typical state volume. This breadth of elevated rankings across assessment, family, coordination, and day treatment codes reinforces the conclusion that the organization operates a high-throughput, multi-modal community behavioral health platform.

Operational orientation toward time-based, non-physician and psychotherapy services is further supported by sizeable billing for codes such as H2012 (behavioral health day treatment), H2014 (skills training and development), and H0015/H0031 mental health and substance use assessment codes. The presence of both short and long psychotherapy codes (90832, 90834, 90837) and family/caregiver training codes (T1027, 97156) suggests mixed delivery modes including individual, family, and caregiver-focused interventions.

The provider’s NPI was enumerated on 2006-01-03 (~20 years ago), indicating long tenure in the market which may have enabled the development of the large Medicaid volumes and deep state-level presence observed across multiple codes. Longevity combined with the extreme outlier rankings suggests an established operational footprint rather than a recent-scale anomaly.

While many CPT/HCPCS entries show extraordinarily high volume relative to peers, several commonly billed outpatient E/M and programmatic codes (99213/99214, H2014, H0031) appear at typical or only modestly elevated percentiles, indicating that while behavioral therapy services dominate revenue, general medical evaluation services and some program codes are present but not the principal revenue drivers. This mix implies a specialization in behavioral health delivery rather than a broad medical outpatient clinic model.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	552,100	$80	$45.3M
H2019	Therapeutic behavioral services, per 15 minutes	287,750	$100	$29.6M
T1027	Family training and counseling for child development, per 15 minutes	177,850	$90	$15.1M
H2012	Behavioral health day treatment, per hour	67,570	$70	$4.6M
H2014	Skills training and development, per 15 minutes	32,300	$140	$4.5M
90882	In this service, the provider works with outside agencies, employers, or other healthcare providers regarding the patient’s physical environment to help manage a psychiatric patient’s medical care.	44,930	$50	$2.3M
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	40,750	$60	$2.3M
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	23,910	$90	$2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	16,710	$120	$2M
90832	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…	30,750	$40	$1.3M

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

South Bay Mental Health Center, Inc. — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	122	150	7,770	$140	$4.8M
H2014	Skills training and development, per 15 minutes	62	190	21,080	$110	$3M
H2019	Therapeutic behavioral services, per 15 minutes	2	290	3,680	$150	$2.9M
T2022	Case management, per month	71	80	7,230	$50	$2.6M
T1027	Family training and counseling for child development, per 15 minutes	4	130	4,300	$110	$2.1M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	26	60	2,800	$110	$659.4K
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	1,620	580	$80	$599.6K
H2012	Behavioral health day treatment, per hour	3	110	840	$70	$575.6K
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…	290	1,020	460	$100	$293.7K
H0032	Mental health service plan development by non-physician	68	160	430	$180	$269.5K

Showing 1–10 of 28

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$309.8M
Old Colony Elderly Services, Inc.	MA	Case Management Agency	$0	$137.5M
Massachusetts Mentor LLC	MA	Foster Care Agency	$0	$95.6M
Brockton Neighborhood Health Center	MA	Federally Qualified Health Center (FQHC)	$0	$91.2M
Sb Transitional Sub, LLC	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$84.8M
Steward Good Samaritan Medical Center, Inc.	MA	General Acute Care Hospital	$0	$64.2M
Pediatric Services Of America, LLC	MA	Nursing Care Agency	$0	$47.8M
South Bay Mental Health Center, Inc.	MA	Adolescent and Children Mental Health Clinic/Center	$0	$43.2M
Sb Transitional Sub, LLC	MA	Early Intervention Provider Agency	$0	$35.9M
Healthier You Wellness Nutrition Partners Of Greater Boston, LLC	MA	Health Maintenance Organization	$0	$33.8M

South Bay Mental Health Center, Inc. — Billing Profile & Reimbursement Data

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South Bay Mental Health Center, 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