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

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

Marshall Pediatric Therapy, LLC (NPI 1104198472)

Field	Value
Entity Type	Organization
Organization	Marshall Pediatric Therapy, LLC
Address	109 Wind Haven Dr Ste 100
City	Nicholasville
State	KY
ZIP	40356
Taxonomy	Pediatric Occupational Therapist
NPI Enumerated	February 2, 2012

Payer Source	Total Paid
Medicaid	$15.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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
S9128	Speech therapy, in the home, per diem	77,560	$80	$6M
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.	75,990	$60	$4.9M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	18,830	$80	$1.5M
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	18,540	$60	$1M
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…	3,500	$150	$538.7K
S9129	Occupational therapy, in the home, per diem	8,480	$60	$500.2K
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…	8,680	$50	$433.8K
S9131	Physical therapy; in the home, per diem	3,100	$60	$195.2K
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…	1,420	$120	$170.2K
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…	5,570	$30	$150.3K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Marshall Pediatric Therapy, LLC — 1 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	114	310	830	$120	$3.7M
S9128	Speech therapy, in the home, per diem	3	30	8,300	$70	$1.7M
S9129	Occupational therapy, in the home, per diem	14	30	7,220	$70	$1.1M
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…	12	40	1,770	$150	$567.9K
S9131	Physical therapy; in the home, per diem	12	20	3,100	$70	$480.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	79	1,270	760	$80	$447.2K
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…	80	340	2,730	$40	$328.2K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	3	30	860	$70	$241.4K
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	540	1,500	$50	$235.7K
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…	10	30	910	$130	$217.1K

Showing 1–10 of 26

Nearby Providers

Other providers in the same ZIP code as Marshall Pediatric Therapy, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dx Solutions, LLC	KY	Clinical Medical Laboratory	$1.9M	$24.9M
Dungarvin Kentucky, LLC - Lexington	KY	Developmentally Disabled Services Day Training Agency	$0	$23.7M
Community Alternatives Kentucky, Inc.	KY	Case Management Agency	$0	$13.8M
Lord's Legacy Life Ministries, Inc.	KY	Developmentally Disabled Services Day Training Agency	$0	$13.8M
Brightview LLC	KY	Methadone Clinic	$0	$11.5M
Revive Ministries Inc	KY	Addiction (Substance Use Disorder) Counselor	$0	$9M
Dennis Griffith	KY	Developmentally Disabled Services Day Training Agency	$0	$8.6M
Revive Ministries Inc	KY	Substance Abuse Rehabilitation Facility	$0	$5.9M
Full Circle Supports, LLC	KY	Developmentally Disabled Services Day Training Agency	$0	$5.2M
Eric Huffman	KY	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.9M

Marshall Pediatric Therapy, LLC — Billing Profile & Reimbursement Data

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Marshall Pediatric Therapy, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References