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

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

Northway Academy, Inc. (NPI 1104333715)

Field	Value
Entity Type	Organization
Organization	Northway Academy, Inc.
Address	108 Doctors Park
City	Saint Cloud
State	MN
ZIP	56303
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	January 4, 2018

Payer Source	Total Paid
Medicaid	$14.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 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…	164,060	$50	$8.5M
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…	82,310	$50	$3.9M
H0032	Mental health service plan development by non-physician	16,530	$80	$1.3M
0365T	Adaptive behavior tx addl	11,840	$50	$556.6K
0364T	Behavior treatment	2,500	$20	$45K
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…	620	$40	$25.5K
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…	80	$210	$16.5K
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	90	$100	$9.5K
0362T	An on–site physician or other qualified healthcare professional, with the assistance of one or more technicians, performs a follow–up assessment of a patient’s maladaptive destructive behavior in an…	50	$30	$1.5K
0368T	Behavior treatment modified additional	30	$40	$1.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Northway Academy, Inc. — 4 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

10 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…	2	50	6,550	$90	$3.1M
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…	2	50	1,140	$70	$720.1K
0365T	Adaptive behavior tx addl	1	10	8,500	$70	$477.1K
H0032	Mental health service plan development by non-physician	9	230	490	$80	$255.2K
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…	10	20	620	$90	$176.9K
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…	9	10	100	$190	$120K
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	3	10	90	$90	$73.4K
0364T	Behavior treatment	3	10	3,090	$20	$54.7K
0362T	An on–site physician or other qualified healthcare professional, with the assistance of one or more technicians, performs a follow–up assessment of a patient’s maladaptive destructive behavior in an…	3	10	530	$30	$16.9K
0368T	Behavior treatment modified additional	3	10	360	$30	$9.2K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northway Academy, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northway Academy, Inc.	MN	Community/Behavioral Health Agency	$0	$10.5M
Northway Academy, Inc.	MN	Community/Behavioral Health Agency	$0	$8.2M
Northway Academy, Inc.	MN	Developmental Disabilities Clinic/Center	$0	$4.6M

Nearby Providers

Other providers in the same ZIP code as Northway Academy, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Cloud Hospital	MN	General Acute Care Hospital	$0	$53.4M
Central Minnesota Mental Health Center	MN	Mental Health Counselor	$0	$36.2M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$20.8M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$19.3M
Eye Kraft Optical, Inc	MN	Eyewear Supplier	$0	$17.7M
Koala Dental Care, LLC	MN	Pediatric Dentistry	$0	$11.3M
Centracare Health Systems	MN	Clinical Medical Laboratory	$1.2M	$9.4M
Centracare Health System	MN	Clinical Medical Laboratory	$345.1K	$9.1M
St. Cloud Area School District 742	MN	Local Education Agency (LEA)	$0	$9.3M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$6.9M

Northway Academy, Inc. — Billing Profile & Reimbursement Data

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Northway Academy, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References