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.

Pediatric Therapy Partners, Inc. (NPI 1104426352)

Field	Value
Entity Type	Organization
Organization	Pediatric Therapy Partners, Inc.
Address	3060 Frontier Way S
City	Fargo
State	ND
ZIP	58104
Taxonomy	Early Intervention Provider Agency
NPI Enumerated	October 27, 2020

Payer Source	Total Paid
Medicaid	$7M
Medicare	$0

Key Findings

This provider is effectively single-payer: Medicare shows none (no Medicare billing on file) while Medicaid accounts for $7M in lifetime revenue, indicating the organization operates almost entirely in the Medicaid space rather than as a mixed Medicare/Medicaid provider. Its NPI was enumerated on 2020-10-27 (~6 years ago), so this Medicaid-focused revenue base was established within a relatively recent operational window.

Revenue is highly concentrated in a small set of Medicaid codes: S5111 ($2.6M, 36.4%), W0500 ($1.6M, 22.3%), and T2024 ($1M, 14.9%) — the precomputed top-3 codes together account for 73.6% of this provider's total Medicaid revenue. This concentration means a small number of service lines drive the vast majority of billing and financial exposure.

The code mix and descriptions point to a home- and waiver-focused early intervention model: S5111 (Home care training, family; per session) and multiple waiver-related codes (T2024 – Service assessment/plan of care development, waiver; T2025 – Waiver services nos; T1023 – Screening for program appropriateness) suggest the provider delivers session-based family training plus care planning and waiver case services consistent with its taxonomy as an Early Intervention Provider Agency. This implies operational emphasis on high-volume home sessions plus targeted assessment/planning engagements.

Operational profile by claims and average paid highlights a two-tier service mix: S5111 has very high volume (18.9K claims) with a $135 avg paid/claim supporting $2.6M in revenue, W0500 similarly shows high volume (10.8K claims) at $145 avg for $1.6M, while T2024 generates $1M from 2.5K claims at a much higher $425 avg paid/claim. These figures indicate the organization relies on large volumes of lower-paid session-based services combined with fewer, higher-paid assessment/planning events to build revenue.

State-level competitive standing is modest rather than dominant: S5111 ranks #4 of 9 providers (63th percentile; typical, unremarkable volume), W0500 ranks #5 of 9 (50th percentile; typical, unremarkable volume), and T2024 ranks #5 of 10 (56th percentile; typical, unremarkable volume), so for its top revenue drivers the provider sits near the middle of the state peer set rather than at the top. Even where it tops a tiny peer group (W0655 is #1 of 3, 100th percentile; typical, unremarkable volume), the associated revenue is small ($28.8K, 0.4%), so leadership there has limited financial impact.

Several Medicaid codes are explicitly labeled as "typical, unremarkable volume" despite varying ranks and percentiles (for example T1023 ranks #4 of 8 at 57th percentile and W0510 ranks #6 of 7 at 17th percentile), which supports the view that this provider’s pattern is conventional for its service type rather than statistically extreme. There are no codes flagged as extreme outliers in the provided list, so the billing profile looks operationally typical within the state market.

Because a single code alone (S5111) accounts for 36.4% ($2.6M) of Medicaid revenue, the provider’s financial performance is sensitive to reimbursement or policy changes affecting that code or session-based home training more broadly. The combination of high claim counts in S5111 and W0500 with a concentrated top-3 share (73.6%) suggests limited product diversification within Medicaid revenue streams, increasing exposure to code-specific rate adjustments or contract changes.

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
S5111	Home care training, family; per session	18,940	$140	$2.6M
W0500	N/A	10,780	$150	$1.6M
T2024	Service assessment/plan of care development, waiver	2,460	$430	$1M
W0530	N/A	1,120	$430	$482K
T2025	Waiver services; not otherwise specified (nos)	1,550	$280	$437.5K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	1,120	$370	$412.5K
W0510	N/A	1,200	$280	$339K
W0520	N/A	320	$430	$137.1K
W0655	N/A	1,070	$30	$28.8K
T1016	Case management, each 15 minutes	600	$20	$13.8K

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

Pediatric Therapy Partners, Inc. — 1 of 10 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5111	Home care training, family; per session	4	10	12,520	$140	$2.8M
W0500	N/A	5	10	10,780	$140	$2M
T2025	Waiver services; not otherwise specified (nos)	7	10	3,670	$300	$1.4M
W0510	N/A	6	10	3,780	$290	$1M
T2024	Service assessment/plan of care development, waiver	5	10	2,140	$410	$880.1K
W0530	N/A	5	10	1,580	$400	$854.1K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	4	10	800	$420	$412.2K
W0520	N/A	5	10	380	$390	$346.3K
T1016	Case management, each 15 minutes	13	20	1,390	$100	$242.6K
W0655	N/A	1	10	970	$100	$80.7K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Therapy Partners, Inc.	MN	Occupational Therapist	$0	$14.1M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marina Gilca	ND	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
Fargo Maple View LLC	ND	Alzheimer Center (Dementia Center)	$0	$4M
Beyond Boundaries Occupational Therapy, Inc.	ND	Multi-Specialty Clinic/Center	$0	$3.9M
Max Johnson	ND	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
St. Sophie's, LLC	ND	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
Shangri-la Home Care	ND	Home Health Agency	$0	$2M
Beyond Boundaries Speech Language Therapy, Inc.	ND	Speech-Language Pathologist	$0	$2M
About Smiles Dental, LLC	ND	Dental Clinic/Center	$0	$1.7M
Center For Pain Medicine Surgery Center LLC	ND	Ambulatory Surgical Clinic/Center	$1.2M	$0
Davita Dakota Dialysis Center LLC	ND	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.2M

Pediatric Therapy Partners, Inc. — Billing Profile & Reimbursement Data

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Pediatric Therapy Partners, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References