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

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

Advanced Physical Therapy, LLC (NPI 1316940505)

Key Findings

Field	Value
Entity Type	Organization
Organization	Advanced Physical Therapy, LLC
Address	5949 W Raymond St
City	Indianapolis
State	IN
ZIP	46241
Taxonomy	Physical Therapist
NPI Enumerated	May 23, 2005

Payer Source	Total Paid
Medicaid	$31.2M
Medicare	$0

This provider is effectively a Medicaid-focused operation: there is no Medicare billing on file while total Medicaid revenue is reported as $31.2M, and the NPI was enumerated 2005-05-23 (~21 years ago), indicating long tenure in the market. The absence of Medicare activity means payer exposure and competitive positioning should be evaluated primarily in the context of state Medicaid dynamics.

Revenue is extremely concentrated in a narrow set of service lines: the precomputed top three Medicaid codes (97530, 97110, 97140) account for 96.1% of the provider's total Medicaid revenue. Specifically, 97530 generated $16.7M (53.4% of Medicaid revenue), 97110 generated $9.9M (31.8%), and 97140 generated $3.4M (10.9%), showing reliance on a small number of high-volume therapy codes.

The code mix indicates a high-volume outpatient physical therapy model focused on active therapeutic interventions and hands-on techniques: 97530 (functional activities), 97110 (therapeutic exercise), and 97140 (manual therapy) form the core of billed services. The predominance of 15-minute unit codes and therapeutic exercise/manual therapy suggests workflows built around repeated short-unit treatment sessions and clinician time devoted to one-on-one therapy.

Volume metrics underline a unit-driven revenue model: the provider reported 417K claims for 97530 at $40 avg paid/claim and 397.2K claims for 97110 at $25 avg paid/claim, indicating that revenue is driven more by exceptionally high claim volumes than by high per-unit rates. These claim counts, combined with the large revenue shares, reinforce that operational capacity and throughput are key drivers of financial performance.

Competitive standing in-state is dominant for core PT codes: 97530 ranks #2 of 404 providers in-state (100th percentile; extreme outlier), 97110 ranks #1 of 487 providers in-state (100th percentile; extreme outlier), and 97140 ranks #1 of 320 providers in-state (100th percentile; extreme outlier). These rankings characterize the provider as a major statewide player for these specific services, far above typical state volume for the same codes.

The provider also bills higher-complexity and evaluation codes at materially elevated levels relative to peers: 97112 shows $631.7K (2.0% of Medicaid revenue) and ranks #5 of 208 providers in-state (98th percentile; notably above typical), while 97163 ($342K, 1.1%) ranks #2 of 21 providers (95th percentile; notably above typical) and 97162 ($170.4K, 0.5%) ranks #2 of 68 providers (99th percentile; extreme outlier). This mix indicates capacity to deliver more complex evaluations and neuromuscular reeducation in addition to routine therapeutic sessions.

Several adjunct modality codes appear with nontrivial claim counts but negligible recorded Medicaid revenue or $0 avg paid/claim, for example 97010 (2.2K claims, $0 avg paid/claim, $0 revenue) and G0283 (562 claims, $0 avg paid/claim, $0 revenue). These line items are characterized as typical or unremarkable in-state and suggest either non-reimbursed ancillary billing patterns under the state reimbursement rules or coding practices that do not materially contribute to revenue.

Given the high concentration in a few codes and the strong statewide dominance for those services, changes in Medicaid policy, fee schedules, or utilization management targeting 97530/97110/97140 could have outsized impact on the provider's revenue profile. For payer/provider analysts, this profile signals both negotiating leverage for the provider in Medicaid networks (because of scale) and a concentration risk if reimbursement or coverage for these specific billed services is adjusted.

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	417,000	$40	$16.7M
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…	397,190	$30	$9.9M
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	213,650	$20	$3.4M
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…	33,250	$20	$631.7K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	7,950	$40	$342K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	3,710	$50	$170.4K
97014	The provider, who is typically a physical therapist, applies an electrical current to nerves or to a muscle or group of muscles, causing them to contract. It is used to restore function to a body…	5,890	$10	$35.3K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	600	$50	$28.7K
97033	In this procedure, the provider administers iontophoresis, which uses electric current to deliver medicine through skin. Use one unit of this code for each 15 minute session.	40	$10	$430
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…	30	$1	$110

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Advanced Physical Therapy, LLC — 5 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	2	400	1,100	$40	$382.2K
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…	1	490	1,080	$30	$162.7K
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…	5	210	640	$20	$74K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	1	320	760	$20	$61.7K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	2	20	130	$40	$42K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	13	80	50	$40	$24.6K
97012	Mechanical traction is a highly successful alternative to surgery. Techniques applied in mechanical traction are dependent on the patient's condition, disorder, tolerance level, and the spinal level…	112	160	890	$10	$24.3K
97014	The provider, who is typically a physical therapist, applies an electrical current to nerves or to a muscle or group of muscles, causing them to contract. It is used to restore function to a body…	24	170	1,110	$10	$23.6K
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…	50	60	270	$1	$16.4K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	2	70	60	$40	$14.4K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Catalina Hamilton Martinez	WI	Physical Therapist	$128.4K	$57.6K
Kevin Majchrzak	IL	Occupational Therapist	$147.2K	$12.8K
Kristopher Harrison	IL	Physical Therapist	$96.4K	$19.8K
Lauren Bruce	IN	Physical Therapist	$108.5K	$0
Kim Springer	IL	Physical Therapist	$95.9K	$0
Bailey Boicken	IN	Physical Therapist	$92.9K	$0
Dinah Bondoc	IL	Physical Therapist	$87.4K	$0
Tracy Benkowski	IL	Physical Therapist	$87.2K	$0
Hisham Qaisi	WI	Physical Therapist	$77.1K	$4.9K
Mark Suthoff	IL	Physical Therapist	$47.1K	$7.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Damar Services Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$53.7M
Aeratech Medical Inc	IN	Oxygen Equipment & Supplies (DME)	$0	$13.1M
Midwest Specialty Surgery Center, LLC	IN	Orthopaedic Surgery Physician	$2.2M	$0
E.m.a.s.inc	IN	Ambulance	$247.4K	$1.1M
Courtney Bumbalough	IN	Family Nurse Practitioner	$284K	$0
Heather Abbott	IN	Primary Care Nurse Practitioner	$258.1K	$0
Patrick Mann	IN	Physician Assistant	$256.4K	$0
Sarah Farmer	IN	Family Nurse Practitioner	$217K	$0
Michael Berend	IN	Orthopaedic Surgery Physician	$212.6K	$0
Joshua Carter	IN	Orthopaedic Surgery Physician	$204.2K	$0

Advanced Physical Therapy, LLC — Billing Profile & Reimbursement Data

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Advanced Physical Therapy, LLC — 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