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NPI 1992256218 · Chicago, IL · Mental Health Clinic/Center (Including Community Mental Health Center)
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Carolina Therapeutic Services, Inc is a mental health clinic/center (including community mental health center) provider located in Chicago, Illinois. This profile covers 0 Medicare and 9 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Carolina Therapeutic Services, Inc |
| Address | 2715 N Central Ave |
| City | Chicago |
| State | IL |
| ZIP | 60639 |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| NPI Enumerated | October 21, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $62.4M |
| Medicare | $0 |
This entity is effectively single-payer in its public-program mix: it has no Medicare billing on file and reports total Medicaid revenue of $62.4M. The absence of Medicare activity indicates the provider’s business is concentrated on Medicaid-covered behavioral health services rather than split between Medicare and Medicaid populations.
Revenue for this provider is highly concentrated: the top three Medicaid codes (H2015, T1016, H0004) account for 89.5% of its total Medicaid revenue. Those top codes individually represent $32M (51.4%), $17.4M (27.8%), and $6.4M (10.3%) of Medicaid revenue respectively, signaling a business highly dependent on a small set of time‑based community behavioral health services.
The code mix—H2015 (Comprehensive community support services, per 15 minutes), T1016 (Case management, each 15 minutes), and H0004 (Behavioral health counseling and therapy, per 15 minutes)—indicates an operational model built around high-volume, time-based outpatient and community mental health services. This pattern is consistent with an intensive service-delivery clinic that focuses on ongoing case management and day-to-day supports rather than one-off procedural care.
For specific codes the provider holds a dominant statewide position: H2015 (125.7K claims, $32M revenue) ranks #9 of 431 providers in-state at the 98th percentile and is labeled an "extreme outlier," while T1016 (132.6K claims, $17.4M revenue) ranks #3 of 465 providers at the 100th percentile and is also an "extreme outlier." These rankings indicate the provider is a major outlier in Illinois for community support and case-management volume, far above typical state volumes for those services.
By contrast, H0004 (48.3K claims, $6.4M revenue) ranks #42 of 804 providers in-state at the 95th percentile and is characterized as typical or unremarkable in volume relative to peers. Other billed codes such as H2017 ($3.3M, 5.3% of Medicaid revenue) and H2000 ($3.1M, 4.9% of Medicaid revenue) appear as smaller, more typical service lines by rank and share, suggesting some program diversity beyond the two dominant codes.
Operational throughput is very high: the provider reported 125.7K claims for H2015 and 132.6K claims for T1016, plus 48.3K claims for H0004, reflecting large client volumes and frequent, short-interval billing typical of per‑15‑minute community and case-management services. These claim counts indicate sustained service intensity and scale in day-to-day behavioral health operations rather than episodic or inpatient care.
Average paid amounts show reimbursement drivers across the top codes: H2015 averaged $255 paid/claim, T1016 averaged $131 paid/claim, and H0004 averaged $133 paid/claim. The relatively higher per‑claim payment on H2015 combined with its large claim volume explains why it is the single largest revenue contributor despite similar service intensity.
The provider has an NPI enumerated on 2016-10-21 (~10 years ago), indicating it has been active for roughly a decade; given the sustained high Medicaid billing documented here, this tenure suggests an established position in Illinois’ community behavioral health market. The combination of long tenure and extreme outlier volumes on core codes likely makes this provider a significant operational node in the state’s Medicaid behavioral health network.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H2015 | Comprehensive community support services, per 15 minutes | 125,680 | $260 | $32M |
| T1016 | Case management, each 15 minutes | 132,550 | $130 | $17.4M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 48,340 | $130 | $6.4M |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 19,160 | $170 | $3.3M |
| H2000 | Comprehensive multidisciplinary evaluation | 23,920 | $130 | $3.1M |
| H2016 | Comprehensive community support services, per diem | 480 | $270 | $130K |
| H0032 | Mental health service plan development by non-physician | 130 | $130 | $15.9K |
| H2011 | Crisis intervention service, per 15 minutes | 40 | $220 | $8.9K |
| 96127 | The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment. | 30 | $20 | $530 |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H2016 | Comprehensive community support services, per diem | 54 | 60 | 11,700 | $130 | $3.5M |
| H2015 | Comprehensive community support services, per 15 minutes | 9 | 430 | 3,260 | $80 | $1.3M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 42 | 800 | 2,480 | $90 | $962.2K |
| H2011 | Crisis intervention service, per 15 minutes | 130 | 160 | 1,060 | $180 | $959.9K |
| H2000 | Comprehensive multidisciplinary evaluation | 23 | 420 | 1,450 | $100 | $631.8K |
| H2017 | Psychosocial rehabilitation services, per 15 minutes | 16 | 60 | 5,920 | $50 | $621.3K |
| T1016 | Case management, each 15 minutes | 3 | 470 | 1,830 | $60 | $475.9K |
| H0032 | Mental health service plan development by non-physician | 140 | 220 | 190 | $60 | $20.2K |
| 96127 | The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment. | 1,128 | 1,410 | 210 | $10 | $9.4K |
Other providers in the same ZIP code as Carolina Therapeutic Services, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Primecare Community Health, Inc. | IL | Federally Qualified Health Center (FQHC) | $0 | $10.1M |
| Rincon Family Services | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $9.3M |
| Cook County | IL | Primary Care Clinic/Center | $0 | $5.9M |
| Christos Tsaliagos | IL | Dentist | $0 | $5.8M |
| Najat George | IL | Family Medicine Physician | $68.5K | $3M |
| James Caruso | IL | Family Medicine Physician | $244.1K | $0 |
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