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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Center For Emotional Health (NPI 1174922348)

Key Findings

Field	Value
Entity Type	Organization
Organization	Center For Emotional Health
Address	640 Summit Cross Place
City	Gastonia
State	NC
ZIP	28054
Taxonomy	Addiction Psychiatry Physician
NPI Enumerated	August 14, 2014

Payer Source	Total Paid
Medicaid	$40.1M
Medicare	$0

CENTER FOR EMOTIONAL HEALTH is effectively a Medicaid-focused practice: it reports no Medicare billing on file and $40.1M in total Medicaid revenue, and its NPI was enumerated 2014-08-14 (~12 years ago), indicating nearly a decade-plus of operation under this billing identity. This profile points to a long-established outpatient behavioral health provider operating almost entirely in the Medicaid market.

Revenue is highly concentrated in three codes: 90837, 99213, and 99214 together account for 91.4% of the provider's Medicaid revenue. That concentration indicates a business model driven by a small set of high-volume services rather than a broad mix of procedure lines.

The code mix shows a psychotherapy- and outpatient E/M–centric operation: 90837 (long psychotherapy) is the single largest revenue driver and 99213/99214 (established patient E/M visits) supply the bulk of the remaining revenue. Specifically, 90837 is reported at 222.9K claims, $85 avg paid/claim, $18.9M revenue (47.2%); 99213 at 162.3K claims, $60 avg paid/claim, $9.7M revenue (24.3%); and 99214 at 91.8K claims, $87 avg paid/claim, $8M revenue (19.9%).

This provider is a dominant in-state player on its top codes: 90837 ranks #1 of 1709 providers in-state (100th percentile; extreme outlier), 99213 ranks #11 of 4130 (100th percentile; extreme outlier), and 99214 ranks #16 of 4404 (100th percentile; extreme outlier). Those ranks and percentiles describe volumes far above typical state providers and suggest market leadership in delivering long psychotherapy sessions and high-volume established-patient visits.

Operational throughput is substantial: the top three codes alone represent very large claim counts (e.g., 222.9K for 90837, 162.3K for 99213, 91.8K for 99214), showing this practice handles very high visit volumes rather than relying on high per-visit reimbursement. The avg paid/claim figures ($85 for 90837, $60 for 99213, $87 for 99214) reinforce that overall revenue is volume-driven.

The provider also reports sizable activity in related outpatient services that expand the clinical footprint: 99204 (new patient E/M) shows 18.8K claims and $2.3M revenue (5.8%), ranking #7 of 1314 in-state (100th percentile; extreme outlier), and 90853 (group psychotherapy) has 11.6K claims and $346.9K revenue, ranking #3 of 234 (99th percentile; extreme outlier). These patterns imply structured intake of new patients and a mix of individual and group treatment formats.

Some ancillary codes fall to more typical in-state volumes, indicating selective use of shorter or higher-complexity services: 90832 (13K claims, $547.5K revenue) ranks #12 of 572 (98th percentile; typical, unremarkable volume), 99215 (215 claims, $26.7K revenue) ranks in the 57th percentile (typical, unremarkable), and 90792 (95 claims, $14.3K revenue) ranks in the 49th percentile (typical, unremarkable). This suggests the practice emphasizes longer psychotherapy and mid-level E/M encounters over brief therapy or frequent high-complexity visits.

From a payer-mix and risk perspective, the absence of Medicare billing combined with $40.1M of Medicaid revenue makes this provider effectively single-payer (Medicaid) in scale; strategic or financial exposure will therefore be heavily tied to Medicaid policy and reimbursement dynamics. Given the extreme outlier status on multiple Medicaid codes, any changes in Medicaid coverage, rates, or authorizations for 90837/99213/99214 would materially affect the practice's revenue base.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	222,940	$90	$18.9M
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…	162,350	$60	$9.7M
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…	91,820	$90	$8M
99204	The provider sees a new 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 provider…	18,840	$120	$2.3M
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…	13,040	$40	$547.5K
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…	11,560	$30	$346.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,800	$90	$169K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	220	$120	$26.7K
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…	100	$150	$14.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Center For Emotional Health — 7 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1	1,710	810	$80	$274.5K
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…	16	4,400	960	$60	$271.3K
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…	11	4,130	670	$50	$219.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	481	1,130	160	$80	$75.6K
99204	The provider sees a new 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 provider…	7	1,310	80	$90	$59.7K
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…	85	170	100	$80	$57.7K
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…	3	230	320	$30	$49.1K
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…	12	570	240	$20	$49K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	32	870	70	$90	$28.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Comprehab LLC	NC	Physical Therapist	$0	$129.7M
Hughes Behavioral And Mental Health Services Inc.	NC	Developmentally Disabled Services Day Training Agency	$0	$59.8M
Gaston Memorial Hospital, Incorporated	NC	General Acute Care Hospital	$0	$49.2M
Carolina Therapeutic Services, Inc	NC	Community/Behavioral Health Agency	$0	$46.7M
Partners Behavioral Health Management	NC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$43.7M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$32.9M
Support Incorporated	NC	Community/Behavioral Health Agency	$0	$19.1M
Gastonia Physician Services, PLLC	NC	Emergency Medicine Physician	$0	$15.8M
Gaston Adolescent Center, Inc.	NC	Community/Behavioral Health Agency	$0	$14.4M
Touchpoint Healthcare Services Inc	NC	In Home Supportive Care Agency	$0	$11.1M

Center For Emotional Health — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References