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

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

Know Boundaries LLC (NPI 1104445600)

Field	Value
Entity Type	Organization
Organization	Know Boundaries LLC
Address	570 Church St E Apt 1301
City	Brentwood
State	TN
ZIP	37027
Taxonomy	Behavior Analyst
NPI Enumerated	April 14, 2020

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 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…	11,890	$180	$2.1M
H2019	Therapeutic behavioral services, per 15 minutes	5,820	$150	$862K
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…	2,130	$110	$228.2K
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…	510	$150	$76.6K
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	$40	$470

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Know Boundaries LLC — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2019	Therapeutic behavioral services, per 15 minutes	16	70	1,820	$110	$574K
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…	5	60	1,760	$170	$564.2K
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…	4	50	440	$120	$89.7K
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…	2	20	70	$130	$19.7K
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…	13	10	40	$60	$9.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Senior Solutions At Home, Inc.	TN	In Home Supportive Care Agency	$0	$58.4M
Sitters Etc., Inc.	TN	In Home Supportive Care Agency	$0	$29.6M
App Of Indiana Ed, PLLC	TN	Emergency Medicine Physician	$0	$26.1M
Maxim Healthcare Services, Inc.	TN	Home Health Agency	$0	$22.2M
Easter Seals Tennessee	TN	Community/Behavioral Health Agency	$0	$12.3M
Accupath Diagnostic Laboratories Inc	TN	Clinical Medical Laboratory	$4.4M	$5.4M
Carr PLLC	TN	Emergency Medicine Physician	$0	$9M
Tn Specialty Dental Services, PLLC	TN	Pediatric Dentistry	$0	$8.7M
Verus Healthcare, LLC	TN	Durable Medical Equipment & Medical Supplies	$0	$7.6M
National Addiction Specialists LLC	TN	Addiction Medicine (Internal Medicine) Physician	$0	$6.3M

Know Boundaries LLC — Billing Profile & Reimbursement Data

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Know Boundaries LLC — Billing Profile & Reimbursement Data

Sign up for Know Boundaries 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