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.

South Carolina Dept Of Mental Health Accounting Office (NPI 1245279595)

Field	Value
Entity Type	Organization
Organization	South Carolina Dept Of Mental Health Accounting Office
Address	801 N Pike W
City	Sumter
State	SC
ZIP	29153
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$28M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $28M in lifetime Medicaid revenue, indicating an effectively single-payer, Medicaid-focused billing profile rather than a mixed Medicare/Medicaid practice. The absence of Medicare activity means competitive and risk assessments should be anchored to Medicaid peer comparisons and state program dynamics.

Revenue is highly concentrated in a small set of outpatient behavioral-health services: the top three Medicaid codes together account for 49.4% of this provider’s total Medicaid revenue. Specifically, 90834 accounts for $5.2M (18.7%), H0031 accounts for $4.6M (16.5%), and 99214 accounts for $4M (14.3%), so nearly half of Medicaid dollars flow through psychotherapy, non-physician mental-health assessments, and higher-level outpatient E/M visits.

The code mix reflects a community mental health clinic model with heavy emphasis on psychotherapy and clinical assessment: high-volume psychotherapy codes (90834 at 36.3K claims and 90837 at 11.7K claims), non-physician assessment H0031 (29.9K claims), and E/M 99214 (23.6K claims) together indicate routine, repeated outpatient therapy and multi-disciplinary case management. Medication administration and nursing support are also material lines of service (J1631 at 9.4K claims and T1002 at 18.2K claims), suggesting integrated medication-delivery and nursing workflows within the clinic.

On competitive standing within South Carolina, the provider is a major in several key service lines: 90834 ranks #12 of 210 providers (95th percentile) and 99214 ranks #57 of 2483 providers (98th percentile), both reflecting volumes well above most in-state peers for those codes. H0031 ranks #9 of 84 (90th percentile) and several psychotherapy codes (90832, 90847, 90837) sit in the low- to mid-90s percentiles, supporting characterization as a dominant regional provider of outpatient therapy and assessments.

There are specific service-level outliers worth noting: J1631 (haloperidol decanoate injections) is ranked #1 of 18 providers in-state (100th percentile) and is described as notably above typical state volume, while code 96372 (therapeutic/prophylactic injection) is labeled an extreme outlier and ranks in the 98th percentile, indicating unusually high injectable-procedure throughput relative to peers. These patterns point to a strong medication-delivery component in addition to psychotherapy.

The provider delivers a broad continuum of behavioral-health services beyond individual psychotherapy: psychosocial rehabilitation H2017 shows 33.8K claims and $1.8M revenue (6.4%), family therapy 90847 produces $1.8M (6.5%), and crisis intervention H2011 is present (615 claims, $81.8K). This spread of billable services (rehab, family work, crisis, and group therapy 90853) is consistent with multi-service community mental health operations rather than a narrow specialty clinic.

Operational scale is evident in raw claim volumes across multiple codes: 36.3K claims for 90834, 29.9K claims for H0031, 33.8K claims for H2017, and 23.6K claims for 99214 together demonstrate sustained high throughput across psychotherapy, assessment, and rehabilitation modalities. Those volumes, paired with top-percentile rankings for several codes, imply significant capacity and patient volume compared with most in-state peers.

The NPI was enumerated on 2006-06-05 (~20 years ago), signaling a long-tenured presence in the state Medicaid market; combined with the multi-service, high-volume Medicaid footprint, this tenure suggests established referral and operational pathways within South Carolina’s public behavioral-health system.

Medicaid: Complete Services Breakdown

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

25 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…	36,260	$140	$5.2M
H0031	Mental health assessment, by non-physician	29,890	$150	$4.6M
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…	23,620	$170	$4M
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…	5,460	$530	$2.9M
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…	11,710	$200	$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…	7,580	$240	$1.8M
H2017	Psychosocial rehabilitation services, per 15 minutes	33,840	$50	$1.8M
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…	18,820	$90	$1.6M
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…	18,770	$70	$1.4M
T1002	Rn services, up to 15 minutes	18,200	$70	$1.3M

Showing 1–10 of 25

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

South Carolina Dept Of Mental Health Accounting Office — 4 of 23 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	12	50	9,030	$60	$1.5M
H0031	Mental health assessment, by non-physician	9	80	180	$150	$1.2M
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…	12	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…	12	90	260	$430	$688.8K
T1002	Rn services, up to 15 minutes	17	100	5,080	$60	$611.2K
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…	54	650	800	$120	$413.8K
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	160	270	$70	$268.1K
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…	20	240	260	$160	$257.9K
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…	133	2,770	210	$60	$254.5K
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…	57	2,480	350	$80	$246K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with South Carolina Dept Of Mental Health Accounting Office, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$65.9M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$61.9M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$47.7M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$40.9M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$40.5M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$40M
South Carolina Department Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$36M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$32M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$30.2M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$29.1M

Nearby Providers

Other providers in the same ZIP code as South Carolina Dept Of Mental Health Accounting Office, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sumter County Disabilities And Special Needs Boards	SC	Early Intervention Provider Agency	$0	$25M
Acsr, Inc.	SC	Adult Day Care Clinic/Center	$0	$3.5M
Med-trans Corporation	SC	Air Ambulance	$577.2K	$263.5K
Bnt Transportation Service LLC	SC	Ambulance	$566.2K	$0

South Carolina Dept Of Mental Health Accounting Office — Billing Profile & Reimbursement Data

Sign up for South Carolina Dept Of Mental Health Accounting Office — Billing Profile & Reimbursement Data policy alerts

South Carolina Dept Of Mental Health Accounting Office — Billing Profile & Reimbursement Data

Sign up for South Carolina Dept Of Mental Health Accounting Office — Billing Profile & Reimbursement Data policy alerts

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