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

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

Helena Occupational Therapy Specialists (NPI 1366855116)

Field	Value
Entity Type	Organization
Organization	Helena Occupational Therapy Specialists
Address	1817 Cannon St
City	Helena
State	MT
ZIP	59601
Taxonomy	Pediatric Occupational Therapist
NPI Enumerated	June 10, 2014

Payer Source	Total Paid
Medicaid	$434.8K
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 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.	4,950	$90	$425.4K
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…	140	$40	$5.8K
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…	130	$30	$3.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Helena Occupational Therapy Specialists — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

3 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.	38	200	1,110	$60	$207.2K
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…	65	90	490	$30	$58.3K
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…	126	160	1,050	$10	$45.3K

Nearby Providers

Other providers in the same ZIP code as Helena Occupational Therapy Specialists, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Mont	MT	Adult Care Home Facility	$0	$34.7M
Intermountain Deaconess Home	MT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.9M
County Of Lewis & Clark Lewis & Clark County School District #1	MT	Local Education Agency (LEA)	$0	$10.8M
Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.9M
Montana Children's Home & Hospital	MT	General Acute Care Hospital	$0	$8.7M
Region Iv Family Outreach, Inc	MT	Case Manager/Care Coordinator	$0	$7.3M
Lewis And Clark Emergency Physicians P C	MT	Emergency Medicine Physician	$0	$6.6M
Montana Independent Living Project	MT	In Home Supportive Care Agency	$0	$6M
St. Peter's Health	MT	Family Medicine Physician	$0	$5.2M
Edgewood Helena Senior Living LLC	MT	Assisted Living Facility	$0	$4.7M

Helena Occupational Therapy Specialists — Billing Profile & Reimbursement Data

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Helena Occupational Therapy Specialists — 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