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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Providence Physical Therapy Associates, Inc. (NPI 1073726733)

Providence Physical Therapy Associates, Inc. is a physical therapy clinic/center provider located in Providence, Rhode Island. This profile covers 0 Medicare and 19 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	Providence Physical Therapy Associates, Inc.
Address	655 Broad St
City	Providence
State	RI
ZIP	02907
Taxonomy	Physical Therapy Clinic/Center
NPI Enumerated	May 8, 2007

Payer Source	Total Paid
Medicaid	$3.4M
Medicare	$0

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	59,590	$20	$1.3M
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	36,640	$20	$842.7K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	6,710	$30	$174.4K
G0283	Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care	23,890	$10	$167.2K
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	13,770	$10	$165.2K
97014	The provider, who is typically a physical therapist, applies an electrical current to nerves or to a muscle or group of muscles, causing them to contract. It is used to restore function to a body…	20,160	$10	$161.3K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	8,080	$20	$145.4K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	3,350	$40	$140.7K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	3,080	$40	$126.3K
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.	3,730	$20	$82.1K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Providence Physical Therapy Associates, Inc. — 12 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	3	360	520	$30	$89.2K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	1	10	1,680	$40	$71.2K
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.	18	260	320	$40	$56K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	2	20	60	$90	$44.5K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	3	250	300	$20	$42.8K
97116	The provider instructs the patient in the proper ways of practicing various exercises, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without…	2	10	180	$140	$40.6K
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	1	10	170	$20	$32K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	1	10	120	$30	$27.7K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	1	10	50	$30	$24.6K
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…	8	160	390	$20	$24K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Independence Health Services, LLC	RI	Home Health Agency	$0	$40.4M
Haigh Ventures, Inc	RI	Home Health Agency	$0	$28.9M
Elmwood Adult Day Health Care Center	RI	Adult Day Care Clinic/Center	$0	$13.8M
Abraham Home Care Provider LLC	RI	In Home Supportive Care Agency	$0	$11.7M
Jammat Housing And Community Development Corporation	RI	Mental Illness Community Based Residential Treatment Facility	$0	$8.7M
Saint Elizabeth Assisted Living, L.P.	RI	Assisted Living Facility	$0	$5M
Raising Hope, Inc	RI	Home Health Agency	$0	$4.9M
Susan Hart	RI	Addiction Medicine (Internal Medicine) Physician	$0	$3.9M
Victa LLC	RI	Addiction Medicine (Internal Medicine) Physician	$57.6K	$3.7M
Aids Care Ocean State, Inc.	RI	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.4M

Providence Physical Therapy Associates, Inc. — Billing Profile & Reimbursement Data

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Providence Physical Therapy Associates, 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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