Optimal Behavioral and Management Group, LLC

Optimal Behavioral and Management Group, LLC was paid $2.58M by Medicaid between Jan 2018 and Dec 2021, across 2 billing codes. Its largest line is T1017, case management, billed per 15 minutes — 90% of everything it billed.

33Billing provider infoOPTIMAL BEHAVIORAL AND MANAGEMENT GROUP, LLC
MARION, SC 29571

33aNPI1649676768assigned 11/17/2014

33bProvider typeProfessional Counselor

28Total paid$2.58M

24GClaims25,600

24DCodes billed2

24AFirst – last monthJan 2018 – Dec 2021

Compared with peers

Next to other Professional Counselor providers in South Carolina

Rank by total paid#3 of 174

Median peer was paid$117K

This provider vs. median22×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration90% of spending on code T1017 with only 2 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	8,023	$848K
2019	11,847	$1.18M
2020	4,663	$444K
2021	1,067	$111K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1017	Case management, billed per 15 minutesTargeted case management, each 15 minutes	90%	22,012	11,215	$2.33M
T1016	Case management, each 15 minutes	9.9%	3,588	2,613	$255K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialPITTMAN, SHANETTA (MANAGER)