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

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

Ati Holdings, LLC (NPI 1396781050)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ati Holdings, LLC
Address	52 Rising Sun Town Ctr
City	Rising Sun
State	MD
ZIP	21911
Taxonomy	Physical Therapy Clinic/Center
NPI Enumerated	June 21, 2006

Payer Source	Total Paid
Medicaid	$30.3M
Medicare	$0

ATI HOLDINGS, LLC is effectively a single-payer Medicaid provider: there is no Medicare billing on file and the provider reports $30.3M in lifetime Medicaid revenue, indicating that Medicaid is the dominant — indeed only recorded — public payer source for this entity. This concentration means any payer- or network-level analysis should treat Medicaid utilization as the principal business activity.

Revenue is highly concentrated in a few therapy codes: the top 3 Medicaid codes by revenue account for 87.0% of this provider's total Medicaid revenue. The leading code, 97110, accounts for $18.1M (59.9% of Medicaid revenue), followed by 97530 at $6M (19.9%) and 97140 at $2.2M (7.2%), indicating most dollars flow through a small set of physical-therapy procedures.

The code mix — dominated by 97110 (therapeutic exercise), 97530 (therapeutic activities), and 97140 (manual therapy) — characterizes ATI as a high-volume outpatient physical therapy operation focused on procedure-based, hands-on therapy services. These codes are consistent with routine rehabilitation visits and functional-improvement treatment plans rather than primarily diagnostic or surgical care.

Operationally ATI shows extremely large claim volumes with relatively low average paid per claim, suggesting a throughput-oriented delivery model: 97110 has 671.9K claims at $27 avg paid/claim and 97530 has 251.4K claims at $24 avg paid/claim. Such high unit counts paired with modest per-claim payments are consistent with frequent, short-duration therapy sessions billed in 15-minute units.

ATI is a statewide outlier and a dominant competitor for core PT services: it ranks #1 of 568 providers in-state for 97110 (100th percentile; extreme outlier) and also ranks #1 for 97530 and 97140 (each described as 100th percentile; extreme outlier). These rankings indicate ATI operates at a scale far above typical in-state peers for these codes.

Beyond treatment codes, ATI also reports substantial evaluation activity across complexity levels: 97163 shows $553.1K (1.8% of revenue), 97162 $237.7K (0.8%), and 97161 $163.1K (0.5%), and each of these evaluation codes ranks at or near the top statewide. This pattern signals routine formal PT evaluations (high, moderate, and low complexity) supporting its large treatment volume.

The dataset includes numerous functional-status G-codes (for example, G8979 with 2.7K claims and $0 revenue, G8978 with 2.3K claims and $0 revenue) that rank #1 in-state; these high-count, $0-paid entries likely reflect systematic reporting of functional limitation and outcome measures in claims separate from reimbursed therapy procedures. Their presence at scale suggests standardized capture of functional-status metrics across episodes of care.

ATI has an established operational history: the NPI was enumerated 2006-06-21 (~20 years ago). Long tenure combined with the provider’s outsized Medicaid volumes and top-state rankings implies established referral relationships or a substantial clinic footprint that sustains unusually high therapy throughput.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	671,870	$30	$18.1M
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.	251,420	$20	$6M
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…	242,300	$10	$2.2M
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…	105,240	$20	$1.9M
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…	17,840	$30	$553.1K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	183,340	$1	$550K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	9,120	$40	$374K
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…	6,790	$40	$237.7K
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…	4,080	$40	$163.1K
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…	25,640	$1	$102.6K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Ati Holdings, LLC — 13 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

24 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.	1	480	740	$50	$220.2K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	2	10	420	$60	$174.4K
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…	1	570	810	$30	$138K
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…	1	350	520	$20	$50.8K
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	640	$10	$49K
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…	1	20	30	$30	$31.8K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	1	120	330	$10	$18.6K
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…	12	30	660	$10	$17.5K
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…	1	120	460	$10	$17.4K
97167	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of high analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	2	10	60	$60	$14.6K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Daniel Altman	MD	Physical Therapist	$230.9K	$24.9K
Eric Lesniak	PA	Physical Therapist	$210.7K	$0
Phillip Tyre	DE	Physical Therapist	$142.9K	$0
Andrew Russell	PA	Physical Therapist	$127.5K	$0
Lisa Cirillo	DE	Physical Therapist	$121.4K	$0
Andrew Smith	DE	Physical Therapist	$113.1K	$0
David Pinkerton	DE	Physical Therapist	$112.2K	$0
Jennifer Andrew	DE	Physical Therapist	$110.7K	$0
Thomas Ballenger	MD	Physical Therapist	$108.8K	$0
Joseph Laws	DE	Physical Therapist	$103K	$0

Ati Holdings, 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

Frequently Asked Questions

References