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.

Partners Behavioral Health Management (NPI 1275809543)

Key Findings

Field	Value
Entity Type	Organization
Organization	Partners Behavioral Health Management
Address	901 S New Hope Rd
City	Gastonia
State	NC
ZIP	28054
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	March 30, 2012

Payer Source	Total Paid
Medicaid	$43.7M
Medicare	$0

This provider is effectively single‑payer: there is no Medicare billing on file, while Medicaid activity dominates with Total Medicaid revenue of $43.7M. The absence of Medicare claims means payer exposure and reporting in this dataset is concentrated entirely in Medicaid.

Revenue concentration is extreme: T1017 is reported with 182.8K claims, $239 avg paid/claim and $43.7M revenue, and the precomputed top‑3 Medicaid codes together account for 100.0% of the provider's Medicaid revenue. In practice that means virtually all recorded Medicaid dollars flow through T1017 rather than through outpatient E/M or psychotherapy codes.

The code mix indicates an operational emphasis on case management: T1017 (Targeted case management, each 15 minutes) drives the revenue base, which aligns with the provider taxonomy of Mental Health Clinic/Center (including community mental health center). While psychotherapy and E/M codes (for example 90832, 90834, 90853, 99213, 99214) appear in the claims list, they report $0 paid/claim and $0 revenue in this dataset, suggesting that billed clinical activity is not the primary source of recorded Medicaid dollars.

Statewide competitive standing for the revenue‑driving service is dominant: T1017 ranks #2 of 216 providers in‑state and is flagged as 100th percentile and an "extreme outlier, far above typical state volume for this code." That rank indicates this provider is a major statewide player for targeted case management relative to peers.

Several common outpatient and behavioral health procedure codes appear with nontrivial claim counts but $0 reported Medicaid revenue (examples include 99214: 1.5K claims, 90832: 649 claims, 90853: 511 claims). These codes mostly rank in mid or lower percentiles statewide (typical, unremarkable volume), which suggests the provider bills a broader set of clinical services on record but does not have those services reflected as Medicaid revenue in this snapshot.

The extreme concentration of Medicaid revenue in a single code creates operational and reimbursement exposure: because $43.7M is tied to T1017, any policy, eligibility, or rate changes affecting targeted case management could materially impact the provider's Medicaid revenue. Analysts should treat the revenue base as highly dependent on continued reimbursement for T1017.

The provider has an established presence in the data: the NPI was enumerated on 2012-03-30 (~14 years ago), indicating roughly a decade‑plus tenure in the Medicare/Medicaid enrollment universe even though Medicare billing is not observed. This tenure supports interpreting the large T1017 volume as an ongoing service focus rather than a short‑term anomaly.

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
T1017	Targeted case management, each 15 minutes	182,770	$240	$43.7M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	200	$0	$0
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…	650	$0	$0
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…	250	$0	$0
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…	510	$0	$0
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…	10	$0	$0
99205	The provider sees a new 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 provider…	100	$0	$0
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,…	180	$0	$0
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…	470	$0	$0
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…	1,520	$0	$0

Showing 1–10 of 18

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

Partners Behavioral Health Management — 1 of 1 code 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	108	120	15,180	$230	$5M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	86	90	45,620	$40	$3.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	139	140	17,630	$80	$1.8M
T1017	Targeted case management, each 15 minutes	2	220	1,700	$150	$1.3M
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…	1,851	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…	2,272	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…	946	1,130	160	$80	$75.6K
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…	285	620	210	$50	$63.1K
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…	1,227	1,310	80	$90	$59.7K
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…	99	230	320	$30	$49.1K

Showing 1–10 of 18

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
Center For Emotional Health	NC	Addiction Psychiatry Physician	$0	$40.1M
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

Partners Behavioral Health Management — Billing Profile & Reimbursement Data

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Partners Behavioral Health Management — 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