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

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

Southwest Behavioral Care, Inc. (NPI 1205980927)

Field	Value
Entity Type	Organization
Organization	Southwest Behavioral Care, Inc.
Address	2 Eastgate Ave
City	Monessen
State	PA
ZIP	15062
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 22, 2007

Payer Source	Total Paid
Medicaid	$28.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 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…	93,630	$110	$10.2M
T1017	Targeted case management, each 15 minutes	37,170	$170	$6.3M
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…	20,690	$140	$3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	11,800	$230	$2.7M
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…	34,710	$60	$1.9M
H0034	Medication training and support, per 15 minutes	12,330	$110	$1.3M
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…	7,990	$120	$919.2K
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…	9,490	$70	$617K
99201	Deleted code, effective Jan. 1, 2021	4,440	$110	$466K
99241	Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…	4,430	$100	$456.1K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Southwest Behavioral Care, Inc. — 4 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	52	210	18,200	$100	$2.9M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	43	100	9,680	$110	$1.5M
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…	15	690	2,240	$80	$1M
H0046	Mental health services, not otherwise specified	158	170	1,200	$130	$909.6K
H0038	Self‑help/peer services, per 15 minutes	91	160	2,290	$150	$865.4K
G9012	Other specified case management service not elsewhere classified	108	320	770	$260	$758K
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…	122	150	2,970	$100	$699.4K
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…	32	560	1,400	$90	$485.7K
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…	17	540	1,490	$50	$316.4K
H0034	Medication training and support, per 15 minutes	23	260	1,710	$80	$279.8K

Showing 1–10 of 18

Nearby Providers

Other providers in the same ZIP code as Southwest Behavioral Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scott Cook	PA	Family Medicine Physician	$130.6K	$3.9M
Victoria Sepesky	PA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$51.2K	$38.6K

Southwest Behavioral Care, Inc. — Billing Profile & Reimbursement Data

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Southwest Behavioral Care, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References