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

Why is the Medicaid comparison limited to North Carolina 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 Carolina (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.

Aces For Autism (NPI 1174978480)

Field	Value
Entity Type	Organization
Organization	Aces For Autism
Address	925 Conference Dr
City	Greenville
State	NC
ZIP	27858
Taxonomy	Clinic/Center
NPI Enumerated	April 25, 2016

Payer Source	Total Paid
Medicaid	$11.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 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…	31,100	$300	$9.4M
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…	10,180	$160	$1.6M
0365T	Adaptive behavior tx addl	2,190	$160	$355.1K
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…	970	$210	$204.2K
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…	1,350	$70	$89K
0364T	Behavior treatment	2,270	$30	$61.3K
0369T	Duodenal mucosal resurfacing, endoscopic	440	$100	$44K
97152	A technician, supervised by a physician or other qualified healthcare professional, provides supporting assessment of a patient’s destructive behavior and behavioral problems by interacting directly…	100	$260	$25.6K
0368T	Behavior treatment modified additional	560	$40	$22.6K
0361T	Multi-slice computer tomography, heart, with contrast material, including 3D image postprocessing; during cardiac catheterization	20	$70	$1.8K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Aces For Autism — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

11 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…	16	90	5,820	$310	$6.4M
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…	16	80	2,260	$190	$1.4M
0365T	Adaptive behavior tx addl	9	10	3,990	$140	$567.1K
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…	15	40	580	$210	$309.6K
97152	A technician, supervised by a physician or other qualified healthcare professional, provides supporting assessment of a patient’s destructive behavior and behavioral problems by interacting directly…	14	30	110	$260	$173K
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…	28	70	1,020	$70	$152.1K
0369T	Duodenal mucosal resurfacing, endoscopic	7	10	550	$170	$142.8K
0364T	Behavior treatment	9	10	4,050	$30	$104.1K
0370T	Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present)	6	10	330	$110	$50.9K
0368T	Behavior treatment modified additional	6	10	630	$50	$46.9K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Aces For Autism, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pride In North Carolina, LLC	NC	Community/Behavioral Health Agency	$0	$98.2M
Pinnacle Home Care, Inc.	NC	Developmentally Disabled Services Day Training Agency	$0	$59.3M
East Carolina University	NC	Internal Medicine Physician	$0	$53.7M
Easter Seals Ucp Nc & Va, Inc.	NC	Community/Behavioral Health Agency	$0	$38.8M
Maxim Healthcare Services, Inc.	NC	Home Health Agency	$0	$35M
Pathways To Life, Inc	NC	Community/Behavioral Health Agency	$0	$30.4M
Behavioral Framework Nc LLC	NC	Behavior Analyst	$0	$29.4M
Venture Rehabilitation Group	NC	Speech-Language Pathologist	$0	$16M
At Home Personal Care Services,inc. Of North Carolina	NC	Home Health Agency	$0	$14.5M
East Carolina Home Care	NC	In Home Supportive Care Agency	$0	$14.5M

Aces For Autism — Billing Profile & Reimbursement Data

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Aces For Autism — 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