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.

Tri-county Therapy, LLC (NPI 1447591607)

Field	Value
Entity Type	Organization
Organization	Tri-county Therapy, LLC
Address	3851 Commercial Center Dr
City	Ladson
State	SC
ZIP	29456
Taxonomy	Speech-Language Pathologist
NPI Enumerated	March 12, 2013

Payer Source	Total Paid
Medicaid	$30.1M
Medicare	$0

Key Findings

TRI-COUNTY THERAPY, LLC reports no Medicare billing on file and is effectively a Medicaid-focused provider, with lifetime Medicaid revenue of $30.1M. The absence of Medicare activity makes Medicaid the dominant — and for practical purposes the sole — payer driving this entity’s billing patterns and financial scale. The provider's NPI has been enumerated since 2013-03-12 (≈13 years), indicating an established presence in the state Medicaid market.

Revenue is highly concentrated in a very small set of service lines: the precomputed top three Medicaid codes account for 98.3% of the provider’s total Medicaid revenue. The single largest code, 92507, generated $15.7M (52.0% of total Medicaid revenue), followed by 97530 with $12.3M (40.9%), and 97110 with $1.6M (5.4%). This concentration means operational and reimbursement changes affecting those specific codes would materially impact overall revenue.

The mix of top codes points to an operation centered on high-volume direct therapeutic services: 92507 (direct treatment for communication and hearing difficulties) and 97530 (direct, activity-based functional performance therapy) together account for 92.9% of Medicaid revenue and indicate the practice delivers large volumes of hands-on speech-language and therapy sessions. The presence of 97110 (therapeutic exercise) as the third revenue driver suggests supplemental therapeutic exercise services are also billed alongside primary speech-language treatments.

Competitive standing in-state is exceptional for the two dominant codes: TRI-COUNTY THERAPY ranks #1 of 339 providers for 92507 and #1 of 345 providers for 97530, both at the 100th percentile and labeled as extreme outliers. Those rankings indicate the provider operates at volumes far above typical state activity for these services and is a dominant statewide supplier of those specific Medicaid-covered therapies. By contrast, 97110 (rank #22 of 285, 93rd percentile) shows a high but more typical in-state footprint for therapeutic exercise.

The provider also shows specialty depth in augmentative communication training: 92609 appears as $294.7K in revenue (1.0% of total Medicaid revenue) and ranks #1 of 17 providers in-state (100th percentile; extreme outlier). Although smaller in dollar terms relative to the top two codes, the top-rank status for 92609 suggests a rare capacity or focus on speech-generating device therapeutic services within the state.

The extreme concentration (98.3% in three codes) creates both strategic advantages and risks: the practice appears to have built scale and possibly clinical protocols around high-throughput delivery of 92507 and 97530, which can be a competitive moat in Medicaid networks; however, it also leaves the provider vulnerable to coding, coverage, or rate changes affecting those few services. Analysts should flag this concentration when modeling revenue sensitivity or negotiating payer contracts.

Several smaller codes appear at typical in-state volumes (for example, 92523 at $79.5K, 97113 at $39.4K, and S9152 at $12.5K), indicating the operation bills a broader set of ancillary evaluations and re-evaluations but without material revenue contribution. These ancillary lines likely support the continuity of care for patients receiving the high-volume direct therapies but do not materially diversify revenue.

From a payer or network planning perspective, TRI-COUNTY THERAPY is a high-volume Medicaid provider of direct speech-language and functional therapy services with an established tenure (NPI since 2013-03-12) and dominant state-level volumes on key codes. Given its lack of Medicare activity and the heavy reliance on a narrow code set, payers should treat the provider as a Medicaid-centric specialty operator whose negotiating leverage and referral value are concentrated in those top-ranked services.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	195,760	$80	$15.7M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	153,850	$80	$12.3M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	22,600	$70	$1.6M
92609	The provider performs therapeutic services to enable the patient to make the best use of his speech generating device and also trains the patient’s caregiver.	5,780	$50	$294.7K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	720	$110	$79.5K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	420	$90	$39.4K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	790	$40	$31K
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	410	$40	$18.1K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	310	$50	$13.9K
S9152	Speech therapy, re-evaluation	240	$50	$12.5K

Showing 1–10 of 13

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

Tri-county Therapy, LLC — 3 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1	340	2,970	$80	$711.1K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	1	350	2,590	$70	$550.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	22	290	2,600	$60	$414.4K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	16	40	390	$40	$65.5K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	9	20	490	$50	$63K
S9152	Speech therapy, re-evaluation	38	100	90	$60	$39K
92609	The provider performs therapeutic services to enable the patient to make the best use of his speech generating device and also trains the patient’s caregiver.	1	20	190	$40	$26.6K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	75	90	170	$20	$25.3K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	5	70	30	$100	$20.7K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	21	60	110	$20	$13.3K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Tri-county Therapy, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pruitthealth Hospice, Inc.	SC	Community Based Hospice Care Agency	$0	$12.9M
Charleston Oral And Facial Surgery, Inc.	SC	Oral and Maxillofacial Surgery (Dentist)	$0	$4.5M
Center For Advanced Surgery LLC	SC	Ambulatory Surgical Clinic/Center	$3.6M	$96.9K
Aging Gracefully, Senior Care Services	SC	Respite Care	$0	$3.6M
Roper St Francis Ancillary Services	SC	Home Health Agency	$0	$3.3M
Pro-med 1 Inc	SC	Customized Equipment (DME)	$0	$2.9M
Roper Saint Francis Physicians Network	SC	Family Medicine Physician	$0	$2.8M
Childrens Eye Specialists LLC	SC	Ophthalmology Physician	$0	$1.8M
Tony Owens	SC	Pain Medicine (Anesthesiology) Physician	$509.8K	$18.4K
David Vroman	SC	Ophthalmology Physician	$476.1K	$0

Tri-county Therapy, LLC — Billing Profile & Reimbursement Data

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Tri-county Therapy, LLC — 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