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 Mentor, Inc. (NPI 1588823900)

Field	Value
Entity Type	Organization
Organization	South Carolina Mentor, Inc.
Address	3600 Forest Drive
City	Columbia
State	SC
ZIP	29204
Taxonomy	Mental Illness Community Based Residential Treatment Facility
NPI Enumerated	June 2, 2008

Payer Source	Total Paid
Medicaid	$54.8M
Medicare	$0

Key Findings

SOUTH CAROLINA MENTOR, INC. reports no Medicare billing on file and $54.8M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) operation at the scale reported. The absence of Medicare revenue means payer exposure is concentrated entirely in state Medicaid policy and reimbursement changes.

Revenue is highly concentrated: the precomputed top three Medicaid codes (T2016, S5145, H2017) account for 95.0% of this provider’s total Medicaid revenue, and T2016 alone represents $39.5M (72.0% of Medicaid revenue). This concentration implies that changes to reimbursement or utilization for those specific codes would disproportionately affect the provider’s overall revenue.

The code mix (T2016 – Habilitation, residential, waiver; per diem; S5145 – Foster care, therapeutic, child; per diem; and H2017 – Psychosocial rehabilitation services, per 15 minutes) points to a business model centered on residential habilitation and therapeutic foster-care services combined with structured psychosocial rehabilitation. This suggests the organization operates primarily as a community-based residential treatment provider delivering long-stay or per-diem services alongside time-based rehab services.

Operational scale is visible in claims volumes for top codes: T2016 has 109.3K claims and S5145 has 150.7K claims, while H2017 has 104.3K claims. These high claim counts are consistent with per-diem and frequent, time-based delivery models and indicate substantial service throughput, particularly for residential and foster-care placements.

Competitive standing is mixed across codes: T2016 ranks #9 of 52 in-state (84th percentile), which places the provider above median but not dominant for residential habilitation; S5145 ranks #2 of 8 (86th percentile), indicating a strong position among a small set of foster-care therapeutic providers; and H2017 ranks #2 of 51 (98th percentile), described as "notably above typical," showing the provider is a leading statewide provider of psychosocial rehabilitation. These rank/percentile signals imply particular market strength in psychosocial rehab and a competitive foothold in foster-care therapeutic services.

Although top three codes dominate revenue, the provider also bills a range of clinical services: 90837 (psychotherapy) generated $873.5K and ranks #69 of 647 in-state (89th percentile), and S9482 (family stabilization services) produced $827K and ranks #4 of 21 (85th percentile). These smaller but nontrivial revenue lines indicate ancillary clinical and family-focused services are part of the care mix, supplementing the core residential and rehab offerings.

The NPI was enumerated 2008-06-02 (~18 years ago), indicating an established tenure in the market that could support long-standing relationships with state Medicaid programs and referral sources. This longevity aligns with the provider’s large Medicaid revenue footprint and high claim volumes on flagship codes.

From a risk and strategic perspective, the business is highly exposed to Medicaid policy or rate shifts for a narrow set of codes (top three = 95.0% of Medicaid revenue). The provider’s notable leadership in H2017 could be leveraged in negotiations or program design, but overall reliance on a few per-diem and rehab codes also concentrates operational and reimbursement risk if utilization rules or eligibility for those services change.

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	109,330	$360	$39.5M
S5145	Foster care, therapeutic, child; per diem	150,700	$50	$7.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	104,310	$50	$5.1M
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…	8,010	$110	$873.5K
S9482	Family stabilization services, per 15 minutes	18,800	$40	$827K
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.	4,240	$110	$445.3K
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…	3,000	$100	$312.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,110	$120	$136.7K
H0032	Mental health service plan development by non-physician	3,600	$20	$82.8K
H0031	Mental health assessment, by non-physician	220	$80	$17.1K

Showing 1–10 of 14

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 Mentor, Inc. — 1 of 14 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	9	50	42,240	$250	$15.4M
S5145	Foster care, therapeutic, child; per diem	2	10	62,970	$60	$5.6M
H2014	Skills training and development, per 15 minutes	12	10	2,400	$120	$1.6M
H2017	Psychosocial rehabilitation services, per 15 minutes	2	50	9,030	$60	$1.5M
H0031	Mental health assessment, by non-physician	39	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…	204	210	320	$130	$707.4K
S9482	Family stabilization services, per 15 minutes	4	20	1,180	$60	$538.2K
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…	69	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…	112	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…	34	240	260	$160	$257.9K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as South Carolina Mentor, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eau Claire Cooperative Health Center, Inc.	SC	Federally Qualified Health Center (FQHC)	$0	$84.5M
County Council For Richland County	SC	Ambulance	$4M	$12.4M
Providence Hospital, LLC	SC	General Acute Care Hospital	$0	$12.7M
Family Preservation Community Services	SC	Community/Behavioral Health Agency	$0	$11.1M
Pediatric Associates, P.A.	SC	Preferred Provider Organization	$0	$7.6M
Two Notch Road Dental Health Center	SC	General Practice Dentistry	$0	$5.7M
She's Counseling Trichology & Consulting LLC	SC	Professional Counselor	$0	$5.4M
Guardian Angel Home Care Services,llc	SC	Home Health Agency	$0	$5.3M
All Medical Inc	SC	Durable Medical Equipment & Medical Supplies	$0	$5M
South Carolina Public Charter School District	SC	Local Education Agency (LEA)	$0	$4.9M

South Carolina Mentor, Inc. — Billing Profile & Reimbursement Data

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South Carolina Mentor, Inc. — 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