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

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

Behavioral Innovations, LLC (NPI 1255500161)

Field	Value
Entity Type	Organization
Organization	Behavioral Innovations, LLC
Address	1206 Romany Rd
City	Kansas City
State	MO
ZIP	64113
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 25, 2008

Payer Source	Total Paid
Medicaid	$7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2021	Day habilitation, waiver; per 15 minutes	26,720	$140	$3.8M
T1016	Case management, each 15 minutes	15,770	$120	$1.9M
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…	5,830	$130	$763.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	3,400	$110	$374.1K
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…	350	$100	$35.4K
0369T	Duodenal mucosal resurfacing, endoscopic	200	$60	$11.7K
S5108	Home care training to home care client, per 15 minutes	60	$160	$10.1K
0368T	Behavior treatment modified additional	210	$50	$9.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Behavioral Innovations, LLC — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2021	Day habilitation, waiver; per 15 minutes	62	170	18,890	$180	$5.4M
H0004	Behavioral health counseling and therapy, per 15 minutes	21	40	3,680	$30	$978K
S5108	Home care training to home care client, per 15 minutes	38	40	6,430	$70	$794.4K
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…	12	70	2,030	$140	$460.6K
T1016	Case management, each 15 minutes	1	10	1,710	$110	$304.2K
0369T	Duodenal mucosal resurfacing, endoscopic	13	10	590	$100	$63.9K
0368T	Behavior treatment modified additional	14	20	530	$40	$24.9K
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…	2	10	70	$100	$16.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Missouri Cvs Pharmacy, L.L.C.	MO	Pharmacy	$125.2K	$0
Nathan Saucier	MO	Vascular & Interventional Radiology Physician	$29.6K	$0

Behavioral Innovations, LLC — Billing Profile & Reimbursement Data

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Behavioral Innovations, LLC — 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