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

Why is the Medicaid comparison limited to New York 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. New York (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.

City Of New York (NPI 1104981356)

Key Findings

Field	Value
Entity Type	Organization
Organization	City Of New York
Address	65 Court St
City	Brooklyn
State	NY
ZIP	11201
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	December 27, 2006

Payer Source	Total Paid
Medicaid	$300M
Medicare	$0

CITY OF NEW YORK reports no Medicare billing on file and $300M in lifetime Medicaid revenue, making its Medicare footprint effectively nonexistent and its Medicaid business the sole material payer relationship on record for this NPI. This profile should be treated as single-payer (Medicaid) in scale and competitive analysis because there is no Medicare activity to compare.

Revenue concentration is high: the precomputed top three Medicaid codes account for 72.0% of the provider’s total Medicaid revenue, driven by 92508 ($91.4M revenue, 30.5% of Medicaid revenue), 97530 ($80.6M revenue, 26.9%), and 92507 ($43.8M revenue, 14.6%). This concentration indicates that a small set of therapy services dominates the provider’s Medicaid receipts and should be the focus of any service-line or utilization review.

The code mix (92508, 92507, 97530 and other high-volume therapy codes) and the provider taxonomy as a Local Education Agency (LEA) strongly indicate school-based therapy operations: large-volume speech-language and functional/therapeutic activity services consistent with in-school group and individual therapy for children. Code descriptions (group speech treatment for 92508, individual speech for 92507, and functional therapeutic activities for 97530) align with a school-centered clinical model rather than an ambulatory specialty clinic.

CITY OF NEW YORK is a statewide outlier and in many cases a dominant provider for its top codes: 92508 ranks #1 of 400 in-state (100th percentile; extreme outlier), 97530 ranks #1 of 2061 (100th percentile; extreme outlier), and 92507 ranks #2 of 745 (100th percentile; extreme outlier). Those rank and percentile positions indicate the organization operates at volumes far above typical state providers for these therapy services and is a major competitor in school-based therapy reimbursement pools.

Operational delivery appears built for high-volume, short-duration units: 92508 has 3.7M claims at $25 avg paid/claim and 97530 has 1.7M claims at $47 avg paid/claim, while group supervision code 97150 shows 966.2K claims. This claim mix — many hundreds of thousands to millions of small-unit claims — is consistent with structured group sessions and frequent therapy encounters typical of LEA service models.

Beyond the top three, a cluster of other therapy codes also contribute materially and show extreme-state-level volume: 97150 ($17.4M, 5.8%), 97110 ($15.3M, 5.1%), 97532 ($15.3M, 5.1%), 97112 ($13.7M, 4.6%), and 97533 ($12.8M, 4.3%) each rank at or near the top percentiles in-state and are labeled as extreme outliers. These additional high-volume therapy codes reinforce that the provider’s revenue base is concentrated in pediatric/rehabilitative therapy services across multiple CPT codes.

Not all codes are outliers: several procedure lines show typical, unremarkable volume for the state, for example 97140 (9.4K claims, $319.7K revenue) ranks #186 of 1557 (88th percentile; typical, unremarkable volume) and 97124 (2.6K claims, $71.9K revenue) ranks #33 of 177 (82th percentile; typical, unremarkable volume). The presence of these more typical-volume codes suggests the organization also performs routine manual therapy and massage-type services at expected state levels alongside its very large therapy programs.

The NPI was enumerated on 2006-12-27 (~20 years ago), indicating long tenure in Medicaid billing; combined with the $300M Medicaid lifetime revenue and the extreme-state-level volumes on core therapy codes, this points to an established, scalable school-based therapy operation with sustained relationships and capacity for high-volume service delivery in the state.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	3,655,900	$30	$91.4M
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.	1,715,900	$50	$80.6M
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…	521,710	$80	$43.8M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	966,200	$20	$17.4M
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…	413,320	$40	$15.3M
97532	N/A	527,180	$30	$15.3M
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…	351,230	$40	$13.7M
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…	400,380	$30	$12.8M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	104,840	$40	$4.4M
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…	125,870	$30	$3.9M

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

City Of New York — 11 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	2	750	1,800	$80	$785.8K
97532	N/A	1	40	780	$30	$662.9K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	1	400	1,580	$20	$344.8K
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.	1	2,060	1,300	$60	$322.2K
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…	1	160	530	$40	$267.3K
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…	2	2,430	1,310	$40	$257.8K
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…	2	1,320	720	$30	$128K
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	1	10	510	$50	$126.4K
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…	1	360	490	$40	$112.1K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	1	350	1,070	$20	$105.7K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Heart To Heart Home Care, Inc.	NY	Home Health Agency	$0	$1.1B
Alliance For Health	NY	Home Health Agency	$0	$436.9M
New York City Health And Hospitals Corporation	NY	Land Ambulance	$19.9M	$363.8M
Heart To Heart Home Care, Inc.	NY	Home Health Agency	$0	$101.8M
The Brooklyn Hospital Center	NY	General Acute Care Hospital	$0	$92.7M
Planned Parenthood Of Greater New York Inc	NY	Ambulatory Family Planning Facility	$0	$78.2M
Sarah Care Usa	NY	Home Health Agency	$0	$72.8M
Community Counseling And Mediation	NY	Community/Behavioral Health Agency	$0	$42.7M
Catholic Charities Neighborhood Services, Inc.	NY	Mental Illness Community Based Residential Treatment Facility	$0	$27.8M
Catholic Charities Neighborhood Services, Inc.	NY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.2M

City Of New York — Billing Profile & Reimbursement Data

Sign up for City Of New York — Billing Profile & Reimbursement Data policy alerts

City Of New York — Billing Profile & Reimbursement Data

Sign up for City Of New York — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References