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NPI 1538155882 · El Dorado, KS · Mental Health Counselor
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South Central Mental Health Counseling Center, Inc. is a mental health counselor provider located in El Dorado, Kansas. This profile covers 0 Medicare and 24 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | South Central Mental Health Counseling Center, Inc. |
| Address | 2365 W. Central |
| City | El Dorado |
| State | KS |
| ZIP | 67042 |
| Taxonomy | Mental Health Counselor |
| NPI Enumerated | September 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $34.9M |
| Medicare | $0 |
This provider is effectively a Medicaid-focused operation: Medicare revenue is listed as none (no Medicare billing on file) while lifetime Medicaid revenue totals $34.9M, making Medicaid the sole recorded federal payer exposure in the dataset. That single-payer concentration shapes both risk and contracting considerations for payers and network planners.
Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes account for 82.3% of the provider's total Medicaid revenue, driven primarily by H0036 at $21.2M (60.8%), H2017 at $5.6M (16.0%), and T1017 at $1.9M (5.5%). This concentration indicates that changes to reimbursement or utilization for these specific community- and case-management codes would materially affect the provider's revenue.
The code mix signals a community-based mental health and case-management operational model: H0036 (Community psychiatric supportive treatment, face-to-face, per 15 minutes) and H2017 (Psychosocial rehabilitation services, per 15 minutes) together dominate revenue, and T1017 (Targeted case management, each 15 minutes) is also a major line. These per-15-minute units suggest the organization delivers high-volume, time-segmented community services rather than being primarily a medical E&M or acute-care practice, although psychotherapy claim lines (for example 90837) indicate it also provides lengthier psychotherapy sessions.
Competitive standing in-state is strong on several key codes: H0036 ranks #5 of 63 providers in-state (94th percentile; notably above typical state volume for this code) and T1017 ranks #5 of 218 providers in-state (98th percentile; notably above typical state volume for this code). The provider also appears as an outlier for long psychotherapy sessions: 90837 ranks #5 of 731 providers in-state (99th percentile; extreme outlier), indicating unusually high volume of extended psychotherapy relative to peers.
Operational footprint extends beyond 15-minute community contacts: the mix includes home-care and respite lines such as S5150 with $814.5K revenue and S5110 with $328.2K revenue, as well as E&M codes like 99214 ($543.5K revenue) and other psychotherapy codes (90832, 90834). This breadth suggests the organization offers integrated community support, respite, training, and routine outpatient E&M in addition to intensive short-interval therapeutic services.
Utilization intensity is evident in claim counts and unitization: H0036 has 105.1K claims, T1017 has 76.7K claims, H2017 has 63.6K claims, and 90837 has 20.3K claims, reflecting very high per-unit billing for time-segmented services. For payers and analysts, these volumes imply operational scale in delivering repetitive, short-duration services and may warrant review of staffing models, documentation workflows, and network capacity planning.
The provider has an established presence: the NPI was enumerated on 2005-09-22 (~21 years ago), which supports the interpretation that these billing patterns reflect a sustained, mature service line rather than a short-term or newly created program. Longevity may indicate durable referral relationships with local agencies and sustained demand for community mental health supports.
From a payer oversight and network strategy perspective, the combination of single-payer Medicaid dependence (no Medicare billing on file) and the fact that the top three codes make up 82.3% of Medicaid revenue creates both negotiating clarity and concentration risk. Analysts should monitor utilization and reimbursement trends for H0036, H2017, and T1017 closely, since any policy or rate changes to these codes would disproportionately affect the provider's financial profile.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 105,110 | $200 | $21.2M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 63,650 | $90 | $5.6M |
| T1017 | Targeted case management, each 15 minutes | 76,700 | $30 | $1.9M |
| 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… | 20,280 | $90 | $1.7M |
| H2021 | Community-based wrap-around services, per 15 minutes | 12,420 | $90 | $1.2M |
| S5150 | Unskilled respite care, not hospice; per 15 minutes | 4,220 | $190 | $814.5K |
| T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify… | 13,750 | $50 | $632.4K |
| 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… | 15,100 | $40 | $543.5K |
| S5110 | Home care training, family; per 15 minutes | 12,160 | $30 | $328.2K |
| H0038 | Self‑help/peer services, per 15 minutes | 3,270 | $80 | $255K |
Showing 1–10 of 24
How this provider's Medicaid billing volume and revenue compare to other Kansas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Kansas median
24 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify… | 31 | 60 | 21,510 | $90 | $8.5M |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 5 | 60 | 35,080 | $100 | $4.1M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 7 | 60 | 12,570 | $60 | $1.5M |
| H2011 | Crisis intervention service, per 15 minutes | 40 | 50 | 1,840 | $270 | $1.1M |
| S5150 | Unskilled respite care, not hospice; per 15 minutes | 9 | 20 | 3,040 | $150 | $827.4K |
| T1017 | Targeted case management, each 15 minutes | 5 | 220 | 5,390 | $40 | $599.4K |
| H2021 | Community-based wrap-around services, per 15 minutes | 7 | 30 | 3,140 | $60 | $441K |
| 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… | 157 | 1,050 | 560 | $80 | $266.8K |
| H0038 | Self‑help/peer services, per 15 minutes | 23 | 60 | 2,130 | $50 | $223.2K |
| S0311 | Comprehensive management and care coordination for advanced illness, per calendar month | 12 | 30 | 680 | $130 | $182K |
Showing 1–10 of 24
Other providers in the same ZIP code as South Central Mental Health Counseling Center, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Flinthills Services, Inc. | KS | Developmentally Disabled Services Day Training Agency | $0 | $20.7M |
| South Central Mental Health Counseling Center, Inc. | KS | Community/Behavioral Health Agency | $0 | $9.1M |
| Thrive Therapy Of Kansas | KS | Home Health Agency | $0 | $9.1M |
| Associated Home Care | KS | Home Health Registered Nurse | $0 | $4.1M |
| El Dorado Clinic, P.A. | KS | Rural Health Clinic/Center | $0 | $2.2M |
| Butler County Clerk | KS | Land Ambulance | $731.1K | $863.3K |
| Homestead Of El Dorado Operations LLC | KS | Assisted Living Facility | $0 | $1.3M |
| El Dorado Usd #490 | KS | Local Education Agency (LEA) | $0 | $860.8K |
| Usd 490 | KS | Local Education Agency (LEA) | $0 | $805.9K |
| Christopher A Smith Od PA | KS | Optometrist | $0 | $752.7K |
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