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

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

Breakthru Autism Services (NPI 1386035079)

Field	Value
Entity Type	Organization
Organization	Breakthru Autism Services
Address	9720 Capital Ct Ste 400
City	Manassas
State	VA
ZIP	20110
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 17, 2015

Payer Source	Total Paid
Medicaid	$8.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2033	Multisystemic therapy for juveniles, per 15 minutes	12,710	$430	$5.5M
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…	9,810	$150	$1.4M
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…	3,710	$210	$792.9K
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…	2,150	$180	$379.8K
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…	1,510	$200	$298.8K
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…	1,180	$130	$149.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Breakthru Autism Services — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2033	Multisystemic therapy for juveniles, per 15 minutes	27	80	5,390	$210	$3.8M
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…	22	90	4,220	$210	$1.6M
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…	39	90	1,030	$260	$977.2K
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…	3	40	350	$290	$278K
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	1,430	$110	$169.5K
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…	12	50	320	$160	$164.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Uva Prince William Medical Center	VA	General Acute Care Hospital	$0	$45.3M
Virginia Home Care Connection, Inc.	VA	Home Health Agency	$0	$24.8M
Amrit Home Healthcare, LLC	VA	Attendant Care Provider	$0	$23.1M
Caring Hands Of America	VA	In Home Supportive Care Agency	$0	$17.6M
Federal Caregivers Home Care LLC	VA	Home Health Agency	$0	$11M
Kids & Family Dental, P.C.	VA	General Practice Dentistry	$0	$10.9M
Victorious Healthcare Services LLC	VA	Home Health Agency	$0	$10M
Pediatricare Of Northern Virginia, P.C.	VA	Pediatrics Physician	$0	$8.6M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$7.6M
At Home Personal Care Services, LLC	VA	Home Health Agency	$0	$7.2M

Breakthru Autism Services — Billing Profile & Reimbursement Data

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Breakthru Autism Services — 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