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 1568476885)

Field	Value
Entity Type	Organization
Organization	South Carolina Dept Of Mental Health Accounting Office
Address	448 Lakeshore Pkwy
City	Rock Hill
State	SC
ZIP	29730
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 29, 2006

Payer Source	Total Paid
Medicaid	$30.2M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scale: there is no Medicare billing on file while Medicaid lifetime revenue is $30.2M. The absence of Medicare activity alongside sizable Medicaid revenue indicates the organization's patient base and reimbursement exposure are concentrated entirely in the Medicaid population. The NPI was enumerated 2006-07-29 (~20 years ago), demonstrating long-term operation in the state Medicaid market.

Revenue is highly concentrated in a small set of outpatient behavioral-health codes: the precomputed top three Medicaid codes (90834, 99214, H0031) account for 53.9% of the provider’s total Medicaid revenue. Individually those codes produced $7.1M (90834), $5.2M (99214), and $4M (H0031), signaling that psychotherapy, mid-level evaluation & management, and non-physician mental health assessments are the primary revenue drivers. This concentration implies operational focus on sustained outpatient therapy and assessment services.

Psychotherapy services form the core clinical offering: 90834 has 48.3K claims and $7.1M revenue and ranks #9 of 210 providers in-state (96th percentile), described as notably above typical state volume. Shorter psychotherapy visits are also extremely high-volume — 90832 has 44.1K claims, $3.2M revenue and ranks #1 of 163 providers in-state (100th percentile), an extreme outlier compared with peers. The mix of high-volume 90832 and 90834 plus notable 90837 (13.2K claims, $2.7M) indicates a high-throughput outpatient psychotherapy operation offering multiple session lengths.

The practice also carries significant evaluation and management responsibility: 99214 produced 27.7K claims and $5.2M revenue and ranks #40 of 2483 providers in-state (98th percentile), characterized as notably above typical state volume. In addition, psychiatric evaluations billed under 90792 generated 5.8K claims and $3.1M revenue and rank #9 of 85 providers in-state (90th percentile). Together these E/M and psychiatric evaluation volumes suggest clinicians spend substantial time on moderate‑complexity office management and initial diagnostic workups.

Competitive standing across Medicaid codes is mixed but leans toward being a major statewide participant for core outpatient services. The provider ranks in top percentiles for several high-revenue codes (for example, 99214 at the 98th percentile and 90834 at the 96th percentile), indicating a leading position for mid-level E/M and psychotherapy work. For some other codes like H0031 (rank #12 of 84, 87th percentile) the volumes are typical or unremarkable, suggesting depth in specific service lines rather than across every behavioral-health code.

Service mix data show a multidisciplinary outpatient model that includes family therapy, group therapy, and non‑physician plan development: 90847 ($2.7M, rank #7 of 241, 98th percentile), 90846 ($428K), H0031 ($4M), and H0032 ($141.2K) are all present in material quantities. The prominence of family- and group‑oriented codes alongside non‑physician service-plan development and assessments points to clinic-based care with substantial use of non‑physician clinicians and structured treatment planning.

Medication administration and injection services are also present but represent a small share of revenue: 96372 has 19.7K claims for $59.1K revenue and ranks #19 of 409 providers in-state (96th percentile), while injectable antipsychotic codes such as J1631 and J2680 appear with modest revenue ($69.9K and $42K respectively). High claim counts for low‑reimbursing medication-administration codes imply regular in-clinic medication management workflows (e.g., long‑acting injectables or routine injections) that support the psychotherapy and E/M services.

Operationally, the provider’s heavy dependence on a narrow set of Medicaid codes (top three = 53.9% of Medicaid revenue) and complete lack of Medicare billing create sensitivity to Medicaid policy or fee changes affecting psychotherapy, 99214-level E/M, or non‑physician assessment reimbursements. Given the long NPI tenure (~20 years) and strong state‑level rankings on multiple core codes, adjustments to Medicaid reimbursement or service definitions could materially affect revenue and would be a primary area for payer/procurement focus.

Medicaid: Complete Services Breakdown

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

19 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…	48,330	$150	$7.1M
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…	27,680	$190	$5.2M
H0031	Mental health assessment, by non-physician	24,460	$160	$4M
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…	44,130	$70	$3.2M
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…	5,790	$540	$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…	13,160	$210	$2.7M
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…	11,470	$230	$2.7M
T1002	Rn services, up to 15 minutes	13,260	$70	$901.7K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	1,850	$230	$428K
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…	920	$280	$259.4K

Showing 1–10 of 19

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 18 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0031	Mental health assessment, by non-physician	12	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…	9	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…	9	90	260	$430	$688.8K
T1002	Rn services, up to 15 minutes	28	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…	46	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…	1	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…	7	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…	651	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…	40	2,480	350	$80	$246K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	32	150	220	$160	$192.8K

Showing 1–10 of 19

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	$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
Community Medicine Foundation	SC	Federally Qualified Health Center (FQHC)	$0	$11.3M
Dental Access Carolina, LLC	SC	General Practice Dentistry	$0	$10.9M
Bayada Home Health Care, Inc.	SC	Home Health Agency	$0	$6.1M
Rock Hill Treatment Specialists, Inc	SC	Methadone Clinic	$90K	$5.3M
Affinity Health Center	SC	Federally Qualified Health Center (FQHC)	$0	$4.8M
Carolina Pediatric Therapy	SC	Physical Therapist	$0	$4.8M
Rock Hill School District Three	SC	Local Education Agency (LEA)	$0	$3.2M
York County Adult Day Care Services, Inc.	SC	Adult Day Care Clinic/Center	$0	$3M
Providence Care LLC	SC	Community Based Hospice Care Agency	$0	$2M
Brian Colletto Od, Inc	SC	Optometrist	$0	$1.8M

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