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 1427168889)

Field	Value
Entity Type	Organization
Organization	South Carolina Dept Of Mental Health Accounting Office
Address	250 Dewey Ave
City	Spartanburg
State	SC
ZIP	29303
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	August 30, 2006

Payer Source	Total Paid
Medicaid	$40M
Medicare	$0

Key Findings

This entity reports no Medicare billing on file and $40M in lifetime Medicaid revenue, making it effectively a Medicaid-centric provider within the dataset. The precomputed figure shows the top 3 Medicaid codes by revenue account for 52.1% of this provider's total Medicaid revenue, indicating heavy dependence on a narrow set of outpatient behavioral-health services.

The top revenue-driving codes and claim volumes indicate an outpatient, psychotherapy- and E/M-focused operation: 99214 (54.2K claims), 90834 (48.9K claims), 90832 (36.1K claims) and 90837 (16.2K claims) together reflect very large volumes of established-patient medical management and medium- to long-duration psychotherapy sessions. This code mix is consistent with a community mental health center that provides frequent face-to-face therapy and medication management visits rather than inpatient or surgical services.

Revenue concentration is pronounced: 99214 (23.6%), 90834 (17.6%) and H0031 (10.9%) together account for 52.1% of the provider’s Medicaid revenue, per the precomputed share. That level of concentration signals that changes in reimbursement or utilization for these specific codes would have outsized impact on the provider’s overall revenue.

The provider is a major statewide participant for several high-volume codes. 99214 ranks #16 of 2483 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), 90834 ranks #7 of 210 (97th percentile; notably above typical state volume), and 90832 ranks #4 of 163 (98th percentile; extreme outlier), indicating leadership in both E/M and psychotherapy delivery in South Carolina.

Workforce and programmatic implications are visible in the non-physician and ancillary service codes: H0031 (29.9K claims, $4.4M revenue) and H0032 (6K claims, $259K) point to substantial use of non-physician mental health assessments and care planning, while T1002 (28.1K claims) and H2017 (46.4K claims) reflect nursing support and psychosocial rehabilitation capacity. Together these codes suggest the provider operates a multi-disciplinary community behavioral health program using non-physician clinicians and structured rehabilitative services.

The presence of high-volume medication administration and long-acting injectable codes—96372 (30.5K claims, ranks #4 of 409 in-state, 99th percentile; extreme outlier) alongside J1631, J2426 and J2794—shows on-site capability to deliver frequent injections and medication management in addition to psychotherapy. Although these medication-related codes represent smaller shares of revenue, their high claim counts indicate operational throughput for medication delivery is an important service line.

Tenure and stability: the NPI was enumerated 2006-08-30 (~20 years ago), indicating the provider has an established footprint in the market. That longevity, combined with the provider’s high state rankings on multiple codes, aligns with the scale and continuity implied by the claim volumes reported.

While several codes are statewide outliers, a number of service lines remain within typical state volume ranges—examples include H0031 (ranks #10 of 84, 89th percentile; typical, unremarkable) and H2017 (ranks #7 of 51, 88th percentile; typical, unremarkable). This mix signals both concentrated dominance in core outpatient psychotherapy and E/M encounters and a broader, more typical portfolio of rehabilitative and crisis services that support an integrated community mental health model.

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	54,250	$170	$9.4M
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…	48,930	$140	$7M
H0031	Mental health assessment, by non-physician	29,880	$150	$4.4M
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…	6,310	$500	$3.1M
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…	16,220	$190	$3.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	46,360	$70	$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…	36,050	$70	$2.6M
T1002	Rn services, up to 15 minutes	28,150	$70	$2M
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…	5,660	$230	$1.3M
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…	12,840	$100	$1.3M

Showing 1–10 of 23

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 — 5 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	7	50	9,030	$60	$1.5M
H0031	Mental health assessment, by non-physician	10	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…	7	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…	7	90	260	$430	$688.8K
T1002	Rn services, up to 15 minutes	12	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…	35	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…	4	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…	23	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…	194	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…	16	2,480	350	$80	$246K

Showing 1–10 of 23

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 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
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$28M

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
Spartanburg Medical Center	SC	General Acute Care Hospital	$0	$187.7M
Axcess Healthcare Services, LLC	SC	Nursing Care Agency	$0	$98.5M
Spartanburg Medical Center	SC	Emergency Medicine Physician	$0	$17.2M
Spartanburg Medical Center	SC	Family Medicine Physician	$0	$17M
Spartanburg Medical Center	SC	Maternal & Fetal Medicine Physician	$0	$11.5M
Better Beginnings, Inc	SC	Pediatric Occupational Therapist	$0	$6.9M
Whitney Road Dental Health Center, P.C.	SC	General Practice Dentistry	$0	$6.3M
Foothills Pediatric Dentistry, PA	SC	Pediatric Dentistry	$0	$4.9M
Bhg Xxxviii, LLC	SC	Substance Use Disorder Rehabilitation Clinic/Center	$264.8K	$3.5M
Upstate Carolina Radiology PA	SC	Diagnostic Radiology Physician	$0	$3.2M

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

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South Carolina Dept Of Mental Health Accounting Office — 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