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.

Berkeley Citizens Inc (NPI 1982267605)

Field	Value
Entity Type	Organization
Organization	Berkeley Citizens Inc
Address	P0 Drawer 429 1301 Old Hwy 52 South
City	Moncks Corner
State	SC
ZIP	29461
Taxonomy	Early Intervention Provider Agency
NPI Enumerated	April 18, 2019

Payer Source	Total Paid
Medicaid	$27.1M
Medicare	$0

Key Findings

This provider is effectively single-payer in practice: there is no Medicare billing on file and its lifetime Medicaid revenue totals $27.1M, indicating the organization’s reimbursement footprint is concentrated entirely in Medicaid programs. The absence of Medicare activity suggests limited engagement with fee-for-service Medicare populations or services outside Medicaid waiver-based care.

Revenue is highly concentrated in a narrow set of waiver per-diem codes: T2016, T2020, and T2014 together account for 97.9% of the provider’s Medicaid revenue. In dollar terms T2016 generates $20M (73.7% of Medicaid revenue) while T2020 and T2014 each produce about $3.3M (12.1% and 12.0% respectively), so the business performance is tightly coupled to continued authorization and payment of these specific waiver rates.

The code mix indicates the provider operates primarily as a habilitation/waiver services agency with a large residential component. T2016 is labeled “Habilitation, residential, waiver; per diem,” and the dominance of this code alongside day habilitation (T2020) and prevocational habilitation (T2014) points to a service model focused on residential care plus day- and work-related habilitation supports under Medicaid waiver programs.

State-level competitive standing is mixed across the top codes. For the largest line, T2016 ranks #17 of 52 providers and sits at the 69th percentile—consistent with the supplied label “typical, unremarkable volume” for this code. The provider is stronger in day habilitation, where T2020 ranks #7 of 40 (85th percentile), and shows above-median presence in prevocational habilitation with T2014 at #9 of 34 (76th percentile), both described as typical but comparatively higher-performing within the state.

Smaller ancillary service lines make up a negligible share of revenue and reflect middling statewide placement. T1027 and T1016 each contribute under 1% of total Medicaid revenue ($243.9K and $207.7K respectively) and sit near the middle of state distributions (T1027 at #47 of 81, 43th percentile; T1016 at #53 of 102, 49th percentile), while H2025 contributes $131.5K (0.5% of revenue) and ranks #12 of 22 (48th percentile). These codes suggest the provider bills for family training, case management, and employment supports but does not lead the state in those lines.

The provider’s business risk and growth levers are concentrated: with $20M tied to a single residential habilitation per-diem code (T2016) and the top three codes comprising 97.9% of Medicaid revenue, any rate, policy, or utilization changes to these waiver per-diem services would materially affect overall revenue. Conversely, this concentration could simplify operational focus for payers evaluating contract terms or utilization management for waiver-based residential and habilitation services.

The organization’s NPI shows tenure in the market since 2019-04-18 (~7 years ago), indicating several years of operation under current enrollment. This duration, combined with the scale of Medicaid waiver billing ($27.1M) and above-median ranks on key non-residential habilitation lines, suggests an established regional provider specializing in Medicaid waiver habilitation services rather than a new entrant or broad multi-payer health system.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	72,990	$270	$20M
T2020	Day habilitation, waiver; per diem	42,030	$80	$3.3M
T2014	Habilitation, prevocational, waiver; per diem	42,390	$80	$3.3M
T1027	Family training and counseling for child development, per 15 minutes	2,740	$90	$243.9K
T1016	Case management, each 15 minutes	4,150	$50	$207.7K
H2025	Ongoing support to maintain employment, per 15 minutes	2,160	$60	$131.5K

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

Berkeley Citizens Inc — 0 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	17	50	42,240	$250	$15.4M
T2014	Habilitation, prevocational, waiver; per diem	9	30	17,930	$70	$1.9M
T2020	Day habilitation, waiver; per diem	7	40	18,120	$70	$1.8M
T1027	Family training and counseling for child development, per 15 minutes	47	80	3,560	$100	$857.8K
T1016	Case management, each 15 minutes	53	100	4,210	$50	$614.8K
H2025	Ongoing support to maintain employment, per 15 minutes	12	20	2,240	$90	$241.7K

Nearby Providers

Other providers in the same ZIP code as Berkeley Citizens Inc, 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	$20.6M
Berkeley County School District	SC	Local Education Agency (LEA)	$0	$12.7M
Berkeley County Ems	SC	Land Ambulance	$1.3M	$2.3M
Lakeside Family Center	SC	Mental Health Counselor	$0	$2.9M
Delta Pharmacy Inc	SC	Community/Retail Pharmacy	$46.1K	$1.9M
Vantage Speech & Language LLC	SC	Speech-Language Pathologist	$0	$1.6M
Jeffrey Santi	SC	Family Medicine Physician	$283.4K	$0
Jeremy Ackermann	SC	Family Medicine Physician	$282.9K	$0
John Flaugher	SC	Family Medicine Physician	$266.5K	$0
Nathan Averill	SC	Family Medicine Physician	$147.1K	$2.9K

Berkeley Citizens Inc — Billing Profile & Reimbursement Data

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Berkeley Citizens 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