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 Department Of Mental Health Accounting Office (NPI 1952329153)

Field	Value
Entity Type	Organization
Organization	South Carolina Department Of Mental Health Accounting Office
Address	2715 Colonial Dr
City	Columbia
State	SC
ZIP	29203
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 17, 2006

Payer Source	Total Paid
Medicaid	$36M
Medicare	$0

Key Findings

SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH ACCOUNTING OFFICE is effectively a single-payer Medicaid outpatient behavioral health provider: there is no Medicare billing on file and Medicaid revenue totals $36M, indicating operations are concentrated in the state Medicaid program rather than serving Medicare beneficiaries. The provider’s NPI was enumerated on 2006-07-17 (~20 years ago), showing long-established participation in payer networks and likely institutional presence in the state behavioral health system.

Revenue concentration is high: the top three Medicaid codes (99214, 90834, H0031) together account for 56.9% of the provider’s total Medicaid revenue, signalling that a small set of outpatient evaluation/management and psychotherapy/assessment services drive most of its Medicaid payments. That concentration suggests operational focus on scheduled outpatient visits and non-physician mental health assessments as primary billable activity.

The code mix confirms a core service-line of psychotherapy and outpatient evaluation: 99214 (E/M established patient), 90834 (psychotherapy ~38–52 minutes), and H0031 (mental health assessment by non-physician) are the top revenue drivers. High volumes for 90837 (long psychotherapy sessions) and 90792 (psychiatric evaluation with medical services) further indicate a mix of both non-physician and clinician-led diagnostic and treatment services across a range of visit lengths.

Competitive standing in-state is strong on multiple high-value codes. The provider ranks in the 95th–99th percentiles or higher for several top codes—99214 ranks #20 of 2483 providers in SC (99th percentile, extreme outlier), 90834 ranks #10 of 210 (96th percentile, notably above typical), and H0031 ranks #5 of 84 (95th percentile, notably above typical)—which collectively portray the entity as a dominant volume provider for core outpatient mental health services in South Carolina.

Some service lines show extreme or unique volume signatures relative to peers beyond psychotherapy and assessment. The provider is an extreme outlier for 96372 (39.5K claims; ranks #1 of 409, 100th percentile) and for certain long-acting injectable codes such as J2426 and J2680 where it also ranks #1 of small peer groups, suggesting high throughput for medication administration and clinic-based injections in addition to talk therapy and assessments. These patterns point to an operational model that combines psychotherapy, evaluations, and on-site medication delivery.

Payer mix implications: because Medicare revenue is absent, the provider’s financial risk and strategic positioning are tightly coupled to Medicaid policy, reimbursement levels, and state behavioral health contracting. Any shifts in Medicaid coverage, managed care arrangements, or state program design could materially affect the provider’s revenue given the $36M Medicaid concentration and the top-three-code reliance noted above.

Service breadth includes both individual psychotherapy and family/system interventions: substantial billing for 90847 (family psychotherapy with patient present) and 90846 (family psychotherapy without patient) indicates structured family engagement services, while H2017 (psychosocial rehabilitation) and H0038 (peer/self-help) show use of rehabilitative and peer-support modalities alongside clinical psychotherapy. This mix suggests a hybrid of clinical and community-oriented behavioral health programming under the same provider umbrella.

Medicaid: Complete Services Breakdown

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
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…	47,310	$160	$7.4M
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…	47,670	$140	$6.6M
H0031	Mental health assessment, by non-physician	40,060	$160	$6.5M
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…	17,900	$190	$3.5M
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…	6,160	$510	$3.1M
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…	9,430	$230	$2.2M
H2017	Psychosocial rehabilitation services, per 15 minutes	31,210	$60	$1.9M
T1002	Rn services, up to 15 minutes	20,500	$70	$1.4M
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…	15,270	$90	$1.4M
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…	14,490	$70	$1M

Showing 1–10 of 24

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 Department Of Mental Health Accounting Office — 7 of 22 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2017	Psychosocial rehabilitation services, per 15 minutes	15	50	9,030	$60	$1.5M
H0031	Mental health assessment, by non-physician	5	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…	10	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…	8	90	260	$430	$688.8K
T1002	Rn services, up to 15 minutes	16	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…	31	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…	17	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…	14	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…	162	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…	20	2,480	350	$80	$246K

Showing 1–10 of 24

Related Providers

Other providers that share a Tax Identification Number (TIN) with South Carolina Department 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 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	$30.2M
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 Department Of Mental Health Accounting Office, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health Medical Group-midlands	SC	Multi-Specialty Clinic/Center	$0	$77.6M
Prisma Health-midlands	SC	General Acute Care Hospital	$0	$74.6M
Prisma Health-midlands	SC	General Acute Care Hospital	$0	$68.3M
Carolina Pediatrics & Adolescent Care, PA	SC	Pediatrics Physician	$0	$12.3M
Sc House Calls Inc	SC	Family Medicine Physician	$0	$11.6M
Prisma Health Medical Group-midlands	SC	Orthopaedic Surgery Physician	$0	$8.7M
Prisma Health-midlands	SC	General Acute Care Hospital	$0	$7.4M
Prisma Health-midlands	SC	Emergency Medicine Physician	$0	$6.8M
Prisma Health Medical Group-midlands	SC	Developmental - Behavioral Pediatrics Physician	$0	$5.9M
Lexington Richland Alcohol & Drug Abuse Council, Inc.	SC	Substance Use Disorder Rehabilitation Clinic/Center	$0	$5.3M

South Carolina Department Of Mental Health Accounting Office — Billing Profile & Reimbursement Data

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South Carolina Department 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