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.

Sr Plus Behavior Consultants, Inc. (NPI 1992254882)

Field	Value
Entity Type	Organization
Organization	Sr Plus Behavior Consultants, Inc.
Address	3600 Pitchers Pl
City	Little River
State	SC
ZIP	29566
Taxonomy	Behavior Analyst
NPI Enumerated	October 3, 2016

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

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
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	12,070	$180	$2.2M
0365T	Adaptive behavior tx addl	1,810	$110	$197.2K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	470	$150	$68.7K
0364T	Behavior treatment	1,810	$20	$27.1K
0369T	Duodenal mucosal resurfacing, endoscopic	30	$70	$1.9K
0368T	Behavior treatment modified additional	50	$30	$1.3K

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

Sr Plus Behavior Consultants, Inc. — 1 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
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	2	20	1,560	$150	$708.5K
0365T	Adaptive behavior tx addl	5	10	1,600	$70	$446.9K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	7	20	350	$130	$178.9K
0369T	Duodenal mucosal resurfacing, endoscopic	9	10	130	$100	$119.2K
0364T	Behavior treatment	5	10	1,620	$10	$77.3K
0368T	Behavior treatment modified additional	8	10	130	$30	$46K

Nearby Providers

Other providers in the same ZIP code as Sr Plus Behavior Consultants, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Little River Medical Center Inc	SC	Federally Qualified Health Center (FQHC)	$0	$8M
Robert Prinzi	SC	Retina Specialist (Ophthalmology) Physician	$5.7M	$0
Little River Medical Center Inc	SC	Dentist	$0	$4M
Mcleod Physician Associates	SC	Obstetrics & Gynecology Physician	$0	$2.6M
Elite Pain Management, LLC	SC	Pain Medicine Physician	$0	$1.6M
Timothy Gajewski	SC	Urology Physician	$554.7K	$0
Alex Mcgaughy	SC	Ophthalmology Physician	$543.4K	$0
Christopher Walsh	SC	Orthopaedic Surgery Physician	$470.1K	$0
Thirston Phillips	SC	Physical Medicine & Rehabilitation Physician	$454.1K	$0
Lisa Mount	SC	Internal Medicine Physician	$444K	$0

Sr Plus Behavior Consultants, Inc. — Billing Profile & Reimbursement Data

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Sr Plus Behavior Consultants, Inc. — Billing Profile & Reimbursement Data

Sign up for Sr Plus Behavior Consultants, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References