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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Upper Valley Special Education (NPI 1043224744)

Field	Value
Entity Type	Organization
Organization	Upper Valley Special Education
Address	516 Cooper Ave
City	Grafton
State	ND
ZIP	58237
Taxonomy	Speech-Language Pathologist
NPI Enumerated	July 28, 2006

Payer Source	Total Paid
Medicaid	$138.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 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.	4,470	$20	$93.8K
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…	2,840	$20	$42.6K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	170	$10	$1.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Upper Valley Special Education — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

3 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.	22	70	1,950	$60	$387K
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…	25	60	1,860	$60	$348.7K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	14	20	1,290	$20	$62.3K

Nearby Providers

Other providers in the same ZIP code as Upper Valley Special Education, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christian Unity Hospital Corporation	ND	Rural Health Clinic/Center	$0	$736.8K
Valley Ambulance Service Inc	ND	Ambulance	$179.8K	$161K
Expression Speech Therapy	ND	Speech-Language Pathologist	$0	$279.5K
Christian Unity Hospital Corporation	ND	Critical Access Hospital	$0	$204.9K
Heartland Eye Care, P.C.	ND	Optometrist	$0	$177.5K
Kern Family Dentistry, P.C.	ND	Dental Clinic/Center	$0	$129.7K
Walsh County Health District	ND	Public Health or Welfare Agency	$86.1K	$41.6K
Life Skills And Transition Center	ND	Intellectual Disabilities Intermediate Care Facility	$0	$48K
Walsh County Social Services	ND	Case Management Agency	$0	$23K
Grafton Chiropractic Clinic, P.C.	ND	Chiropractor	$0	$16K

Upper Valley Special Education — Billing Profile & Reimbursement Data

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Upper Valley Special Education — Billing Profile & Reimbursement Data

Sign up for Upper Valley Special Education — 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