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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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.

Dearborn Speech And Sensory Center, Inc (NPI 1033510821)

Dearborn Speech And Sensory Center, Inc is a behavior analyst provider located in Plymouth, Michigan. This profile covers 0 Medicare and 26 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	Dearborn Speech And Sensory Center, Inc
Address	44670 Ann Arbor Rd W Ste 130
City	Plymouth
State	MI
ZIP	48170
Taxonomy	Behavior Analyst
NPI Enumerated	September 11, 2014

Payer Source	Total Paid
Medicaid	$47.6M
Medicare	$0

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

26 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…	144,560	$150	$22.3M
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…	43,200	$170	$7.1M
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…	117,270	$60	$6.9M
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.	81,280	$80	$6.8M
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	9,680	$80	$745.2K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	1,770	$390	$688.3K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	13,160	$40	$539.7K
0365T	Adaptive behavior tx addl	2,540	$210	$523.2K
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…	12,340	$40	$493.6K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	3,790	$130	$481.6K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Dearborn Speech And Sensory Center, Inc — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

26 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…	7	130	11,590	$190	$7.6M
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…	6	130	3,170	$180	$2.2M
0365T	Adaptive behavior tx addl	46	70	3,180	$170	$1.5M
H0031	Mental health assessment, by non-physician	172	180	1,290	$250	$1.1M
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…	1	160	2,030	$60	$407.6K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	8	60	200	$380	$398.1K
0369T	Duodenal mucosal resurfacing, endoscopic	39	70	740	$160	$299.1K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	7	100	910	$90	$283.6K
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.	6	390	1,660	$40	$281.8K
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…	102	550	2,350	$30	$240.6K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Personalized Nursing Light House, Inc.	MI	Substance Use Disorder Rehabilitation Clinic/Center	$0	$25.6M
Kci Usa, Inc.	MI	Durable Medical Equipment & Medical Supplies	$0	$9.6M
Transformational Services LLC	MI	Clinical Social Worker	$0	$6.4M
Lincare Inc.	MI	Durable Medical Equipment & Medical Supplies	$0	$5.8M
Rapid Biosense LLC	MI	Clinical Medical Laboratory	$59.1K	$1.6M
Ultra-x Imaging LLC	MI	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$814.8K	$300.1K
Naman Jhaveri	MI	Infectious Disease Physician	$449K	$47.7K
Kalyani Movva	MI	Specialist	$416.2K	$0
Hend Abdul-jauwad	MI	Infectious Disease Physician	$246.9K	$0
Praveen Modi	MI	Internal Medicine Physician	$234K	$0

Dearborn Speech And Sensory Center, Inc — Billing Profile & Reimbursement Data

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Dearborn Speech And Sensory Center, 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