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

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

Rise Autism LLC (NPI 1053907808)

Field	Value
Entity Type	Organization
Organization	Rise Autism LLC
Address	239 E Winslow Rd
City	Bloomington
State	IN
ZIP	47401
Taxonomy	Behavior Analyst
NPI Enumerated	December 16, 2020

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 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…	2,300	$1,630	$3.8M
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…	510	$390	$195.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Rise Autism LLC — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

2 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…	62	100	3,740	$430	$7.7M
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…	61	80	1,360	$150	$1M

Nearby Providers

Other providers in the same ZIP code as Rise Autism LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Options For Better Living, Inc	IN	Developmentally Disabled Services Day Training Agency	$0	$23.2M
Southern Indiana Pediatric Dentistry, LLC	IN	Pediatric Dentistry	$0	$3.7M
Timothy Devitt	IN	Oral and Maxillofacial Surgery (Dentist)	$0	$3.1M
Bloomington Oral Surgery	IN	Oral and Maxillofacial Surgery (Dentist)	$0	$2.7M
Rebecca Taylor	IN	Family Nurse Practitioner	$609K	$0
Hideki Kawanishi	IN	Nephrology Physician	$233.3K	$0
Hook-superx LLC	IN	Pharmacy	$192.7K	$0
Melissa Hullinger	IN	Family Medicine Physician	$147.7K	$0
Gerry Hash	IN	Foot & Ankle Surgery Podiatrist	$143.3K	$0
Kroger Limited Partnership I	IN	Community/Retail Pharmacy	$116.6K	$0

Rise Autism LLC — Billing Profile & Reimbursement Data

Sign up for Rise Autism LLC — Billing Profile & Reimbursement Data policy alerts

Rise Autism LLC — Billing Profile & Reimbursement Data

Sign up for Rise Autism LLC — 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