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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Sunshine Behavioral Health Center, LLC (NPI 1952813503)

Field	Value
Entity Type	Organization
Organization	Sunshine Behavioral Health Center, LLC
Address	18125 Highway 43
City	Mount Vernon
State	AL
ZIP	36560
Taxonomy	Mental Health Counselor
NPI Enumerated	November 3, 2017

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 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…	11,810	$60	$720.4K
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…	4,920	$60	$290.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	310	$70	$20.9K
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.	160	$40	$6.3K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.

Claims Volume vs. Alabama Distribution

Sunshine Behavioral Health Center, LLC — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	57	180	100	$120	$381.8K
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…	18	380	440	$90	$362K
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…	17	120	730	$60	$212.5K
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.	23	50	100	$70	$72.6K

Sunshine Behavioral Health Center, LLC — Billing Profile & Reimbursement Data

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Sunshine Behavioral Health Center, LLC — Billing Profile & Reimbursement Data

Sign up for Sunshine Behavioral Health Center, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References