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

Why is the Medicaid comparison limited to South 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. South 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.

Regenesis Organization Community Health Center (NPI 1194710426)

Key Findings

Field	Value
Entity Type	Organization
Organization	Regenesis Organization Community Health Center
Address	750 S. Church Street
City	Spartanburg
State	SC
ZIP	29306
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 13, 2005

Payer Source	Total Paid
Medicaid	$23.5M
Medicare	$0

REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER is effectively a Medicaid-focused provider: there is no Medicare billing on file while lifetime Medicaid revenue is $23.5M, so the organization's reimbursement picture is concentrated in Medicaid rather than split across Medicare and Medicaid. This makes Medicaid policy, rate changes, and managed-Medicaid contracting the principal financial levers for the organization.

Revenue concentration is high: the precomputed top three Medicaid codes (99213, 90832, T1015) account for 76.8% of the provider’s total Medicaid revenue. Specifically, 99213 generates $10M (42.6%), 90832 generates $5.5M (23.5%), and T1015 generates $2.5M (10.7%), indicating reliance on a small set of high-volume services.

The code mix points to an FQHC operating model that blends primary care and embedded behavioral health: high volumes of E/M established visit codes (99213 and 99214) plus large psychotherapy volume (90832 and supporting psychotherapy codes) alongside the FQHC all-inclusive encounter code T1015. This pattern is consistent with a community health center providing routine primary care, pediatric preventive care, and integrated mental-health services on-site.

Competitive standing for the high-volume E/M and psychotherapy services is strong in-state. 99213 ranks #34 of 2766 providers in-state (99th percentile; notably above typical state volume for this code), marking REGENESIS as one of the largest statewide billers of routine established outpatient visits, while 90832 ranks #7 of 163 providers (96th percentile; notably above typical state volume for this code), positioning the center as a major provider of short psychotherapy sessions in South Carolina.

While the three top codes dominate revenue, the broader service portfolio includes measurable pediatric and preventive care activity: 99393 (3.3K claims, $644.6K; 2.8%) and 99394 (2.3K claims, $441.2K; 1.9%) show ongoing well-child and adolescent preventive visits, and immunization claims such as 90460 (4.4K claims, $122.9K; 0.5%) indicate routine vaccination delivery consistent with a full-scope FQHC. These codes demonstrate the organization maintains primary care preventive capacity in addition to its high-volume adult E/M and behavioral health lines.

The provider also shows investment in longitudinal care management and some ancillary services: 99490 (3.5K claims, $107.6K; 0.5%) ranks #7 of 58 providers in-state (89th percentile; typical, unremarkable volume for this code), which suggests active chronic care management programs, and diagnostic and screening services (87426, 87637, 80305) appear at modest volumes that support clinic-based care. These ancillary lines supplement the core primary-care and behavioral-health revenue streams.

There are notable statistical outliers within the Medicaid profile that reveal both strengths and gaps. The organization is a standout for new/established pediatric well visits on select codes—99382 ranks #2 of 15 providers in-state (93th percentile; notably above typical state volume for this code)—while some longer psychotherapy sessions such as 90837 appear at relatively low percentile placement (90837 ranks #572 of 647 providers in-state, 11th percentile; typical, unremarkable volume for this code), suggesting a focus on shorter psychotherapy formats (e.g., 90832) rather than a predominance of extended-session psychotherapy.

Long tenure supports an established local presence: the NPI was enumerated on 2005-09-13 (~21 years ago), indicating the organization has been operating in the market for two decades. That longevity, paired with the high-state rankings on key codes, suggests entrenched referral patterns and operational scale in its service area, but also a revenue profile that could be sensitive to policy or rate changes affecting its few dominant codes.

Medicaid: Complete Services Breakdown

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

81 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	53,880	$190	$10M
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…	28,750	$190	$5.5M
T1015	Clinic visit/encounter, all-inclusive	21,600	$120	$2.5M
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…	12,320	$190	$2.4M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,270	$200	$644.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,520	$190	$468K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,520	$180	$460.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,250	$200	$441.2K
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…	1,130	$190	$216.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	680	$190	$129.7K

Showing 1–10 of 81

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Regenesis Organization Community Health Center — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

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

81 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	64	210	320	$130	$707.4K
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…	65	90	260	$430	$688.8K
T1015	Clinic visit/encounter, all-inclusive	61	350	3,560	$30	$525.5K
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…	572	650	800	$120	$413.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	138	280	600	$90	$299K
0241U	N/A	45	50	1,840	$90	$291.4K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	37	60	540	$110	$271.5K
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…	7	160	270	$70	$268.1K
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…	34	2,770	210	$60	$254.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	418	710	350	$60	$247.2K

Showing 1–10 of 81

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Traditions Hospice Of Greenville, LLC	SC	Community Based Hospice Care Agency	$0	$17.9M
Carolina Dental Docs LLC General Dentistry For Kids	SC	General Practice Dentistry	$0	$4.2M
New Day, Inc. Of Spartanburg	SC	Community/Behavioral Health Agency	$0	$2.8M
Christopher Thompson	SC	Medical Physician Assistant	$616.1K	$0
Pamela Mills	SC	Family Nurse Practitioner	$366.6K	$0
Michael Jordan	SC	Primary Podiatric Medicine Podiatrist	$143.5K	$0
Paul Morris	SC	Chiropractor	$48.1K	$0

Regenesis Organization Community Health Center — Billing Profile & Reimbursement Data

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Regenesis Organization Community Health Center — 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