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.

Medical University Hospital Authority (NPI 1841341708)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medical University Hospital Authority
Address	171 Ashley Ave
City	Charleston
State	SC
ZIP	29425
Taxonomy	Psychologist
NPI Enumerated	January 16, 2007

Payer Source	Total Paid
Medicaid	$32.6M
Medicare	$0

This provider is effectively single‑payer in its claims footprint: there is no Medicare billing on file while total Medicaid revenue is $32.6M, indicating the organization’s clinical and billing activity (at least in public data) is concentrated in the Medicaid program. Analysts should treat Medicaid as the primary revenue and utilization lens for competitive and operational assessment.

Revenue concentration is high: the precomputed top‑3 Medicaid codes account for 50.8% of the provider’s Medicaid revenue, driven by 90837 ($7.4M, 22.7%), 99214 ($5.1M, 15.6%), and 90853 ($4.1M, 12.6%). This level of concentration signals that a small set of psychotherapy and E/M services dominate the provider’s Medicaid earnings.

The code mix points to a core ambulatory behavioral health operation delivering high volumes of psychotherapy and related psychiatric services: large revenue and claim counts for 90837, 90834, 90832, 90853, 90847 and evaluation codes such as 90792 and 99214 indicate a blended model of individual therapy, group therapy, family therapy, and medical management. The presence of both psychotherapy add‑ons (90833, 90836, 90838) and standard E/M codes suggests integrated therapy plus psychiatric evaluation/management at outpatient sites.

State competitive standing is strong on several high‑value codes: 90837 ranks #12 of 647 providers in the state (98th percentile; extreme outlier) and 90853 ranks #2 of 59 (98th percentile; extreme outlier), while 99214 ranks #22 of 2483 providers (99th percentile; notably above typical volume). These ranks indicate the provider is a major in‑state supplier of long individual psychotherapy and group psychotherapy services relative to peers.

Service intensity and reimbursement patterns favor longer sessions: average paid/claim for 90837 is $278 and for 90847 is $306, while 90853 averages $127 per claim and 99214 averages $113 per claim. This implies revenue is pulled by longer-duration psychotherapy and family therapy encounters (higher per-claim payments) combined with very high claim volume for certain group and office E/M services.

The provider’s Medicaid portfolio also includes community and assessment services beyond psychotherapy: H2017 (psychosocial rehabilitation) accounts for $2M (6.1%) and H0031 (mental health assessment, non‑physician) accounts for $826.8K (2.5%). These items, together with high counts of 90791/90792, suggest a broader outpatient mental health program offering rehabilitation and diagnostic assessment in addition to therapy.

Several codes show statistical outlier behavior or niche dominance within the state: 90792 ranks #2 of 85 providers (99th percentile; extreme outlier), 90836 ranks #1 of 18 (100th percentile; notably above typical volume), and 90833 ranks #3 of 58 (96th percentile; notably above typical volume). Those rankings point to particular strength in psychiatric evaluations and combined psychotherapy+E/M add‑on services relative to in‑state peers.

The provider has an established billing presence over time, with NPI enumeration on 2007-01-16 (~19 years ago), which together with $32.6M lifetime Medicaid revenue suggests a sustained, long‑standing Medicaid practice likely supported by established referral streams and payer relationships. This tenure should be considered when evaluating contracting leverage and continuity of service lines in the local behavioral health market.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	26,630	$280	$7.4M
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…	45,010	$110	$5.1M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	32,300	$130	$4.1M
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…	16,350	$190	$3M
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…	9,080	$310	$2.8M
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…	9,700	$230	$2.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	21,080	$90	$2M
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.	4,640	$310	$1.5M
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…	14,130	$100	$1.4M
H0031	Mental health assessment, by non-physician	4,810	$170	$826.8K

Showing 1–10 of 21

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

Medical University Hospital Authority — 8 of 20 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	18	50	9,030	$60	$1.5M
H0031	Mental health assessment, by non-physician	21	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…	21	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…	2	90	260	$430	$688.8K
T1002	Rn services, up to 15 minutes	102	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…	12	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…	20	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…	15	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…	196	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…	22	2,480	350	$80	$246K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Musc Affiliate Physicians	SC	Family Medicine Physician	$0	$14.7M
University Medical Associates	SC	Pediatrics Physician	$0	$9.2M
University Medical Associates Of The Medical University Of South Carol	SC	Obstetrics & Gynecology Physician	$0	$6.1M
University Medical Associates Of The Medical University Of South Carol	SC	Diagnostic Radiology Physician	$0	$5.4M
University Medical Associates Of The Medical University Of South Carol	SC	Emergency Medicine Physician	$0	$3.6M
University Medical Associates Of The Medical University Of South Carol	SC	Pediatrics Physician	$0	$3.5M
University Medical Associates Of The Medical University Of South Carol	SC	Psychiatry Physician	$0	$3.3M
Rosalee Unwin	SC	Family Nurse Practitioner	$2.9M	$0
Jennifer Douglas	SC	Physician Assistant	$2.9M	$0
University Medical Associates Of The Medical University Of South Carol	SC	Multi-Specialty Clinic/Center	$0	$2.8M

Medical University Hospital Authority — Billing Profile & Reimbursement Data

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Medical University Hospital Authority — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$241.1M
University Medical Associates Of The Medical University Of South Carol	SC	Family Medicine Physician	$0	$56.6M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$28.3M
Providence Hospital, LLC	SC	General Acute Care Hospital	$0	$12.7M
Medical University Hospital Authority	SC	Pediatrics Physician	$0	$12.4M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$12.1M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$8.7M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$8.5M
Kershaw Hospital LLC	SC	General Acute Care Hospital	$0	$8M
Medical University Hospital Authority	SC	General Acute Care Hospital	$0	$7M