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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Milestones Physical Therapy, Inc. (NPI 1003950163)

Milestones Physical Therapy, Inc. is a physical therapist provider located in Hurricane, West Virginia. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Milestones Physical Therapy, Inc.
Address	179 Station Place Way
City	Hurricane
State	WV
ZIP	25526
Taxonomy	Physical Therapist
NPI Enumerated	February 20, 2007

Payer Source	Total Paid
Medicaid	$3.1M
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	16,940	$80	$1.3M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	21,010	$50	$1M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	6,210	$60	$385.1K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	3,790	$60	$208.2K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	520	$150	$75.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	660	$50	$33.5K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	350	$80	$28.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	30	$100	$2.8K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	30	$60	$1.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	20	$60	$1.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Milestones Physical Therapy, Inc. — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	4	140	790	$90	$469.7K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	2	80	1,150	$40	$142.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	46	210	1,780	$30	$125.8K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	2	10	920	$50	$111.3K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	4	10	670	$70	$72.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	197	210	280	$40	$59.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	93	200	490	$30	$57.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	139	190	100	$80	$29.7K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	2	10	40	$130	$23.2K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	8	10	40	$40	$8.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Drs Martin & Kirk PLLC	WV	Pediatric Dentistry	$0	$14.2M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$8.6M
Active Medical LLC	WV	Durable Medical Equipment & Medical Supplies	$0	$5.2M
Wv Wellness And Recovery LLC	WV	Medical Specialty Clinic/Center	$0	$2.4M
Cardiovascular Consultants PLLC	WV	Cardiovascular Disease Physician	$0	$2.4M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1M
Valley Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$894.9K
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$838.1K
James Toothman	WV	Internal Medicine Physician	$528.3K	$19.8K
M Haffar	WV	Cardiovascular Disease Physician	$358.4K	$0

Milestones Physical Therapy, Inc. — Billing Profile & Reimbursement Data

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Milestones Physical Therapy, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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References