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

Why is the Medicaid comparison limited to Tennessee 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. Tennessee (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.

Sbh-kingsport (NPI 1174038749)

Sbh-kingsport is a psychiatric hospital provider located in Kingsport, Tennessee. This profile covers 0 Medicare and 12 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	Sbh-kingsport
Address	1025 Executive Park Blvd
City	Kingsport
State	TN
ZIP	37660
Taxonomy	Psychiatric Hospital
NPI Enumerated	December 5, 2017

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	42,760	$30	$1.4M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	4,230	$210	$900.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10,430	$90	$896.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	6,550	$40	$281.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6,480	$40	$246.1K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	1,450	$90	$133.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	5,050	$20	$101.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	890	$40	$37.4K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	230	$50	$11.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	130	$60	$7.6K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Sbh-kingsport — 3 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0035	Mental health partial hospitalization, treatment, less than 24 hours	9	20	3,220	$130	$2.9M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	51	310	110	$70	$142.8K
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…	137	200	130	$60	$86.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	50	550	290	$30	$77K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	18	840	440	$20	$73K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7	480	160	$50	$46.3K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	30	110	510	$20	$43.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	254	310	160	$40	$37.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	26	260	280	$20	$35.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	9	280	110	$30	$29K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fay Bembry	TN	Psychiatric/Mental Health Nurse Practitioner	$207K	$57.1K
Hetal Brahmbhatt	TN	Psychiatry Physician	$6.7K	$26.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Holston Medical Group PC	TN	Family Medicine Physician	$0	$37M
Wellmont Medical Associates Inc	TN	Pulmonary Disease Physician	$0	$27.8M
Wellmont Health System	TN	General Acute Care Hospital	$0	$17.6M
Mountain States Health Alliance	TN	General Acute Care Hospital	$0	$15.5M
Watauga Dental Center, PLLC	TN	General Practice Dentistry	$0	$8M
Lovinginhomecareinc	TN	In Home Supportive Care Agency	$0	$5.3M
Harville Orthodontics PLLC	TN	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.7M
Thompson Delivery Services LLC	TN	Non-emergency Medical Transport (VAN)	$0	$3.2M
Wellmont Cardiology Services	TN	Cardiovascular Disease Physician	$0	$3.1M
Blue Ridge Medical Management Corporation	TN	Pediatrics Physician	$0	$2.9M

Sbh-kingsport — Billing Profile & Reimbursement Data

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Sbh-kingsport — 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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