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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Children's Specialized Hospital (NPI 1396886297)

Key Findings

Field	Value
Entity Type	Organization
Organization	Children's Specialized Hospital
Address	200 Somerset St
City	New Brunswick
State	NJ
ZIP	08901
Taxonomy	Children's Rehabilitation Hospital
NPI Enumerated	February 12, 2007

Payer Source	Total Paid
Medicaid	$200M
Medicare	$0

CHILDREN'S SPECIALIZED HOSPITAL is effectively a single‑payer Medicaid provider: total Medicaid revenue is $200M and there is no Medicare billing on file. The absence of Medicare activity indicates the organization’s patient and payer mix is overwhelmingly focused on Medicaid-covered pediatric services rather than Medicare populations.

Revenue is highly concentrated in a small set of therapy and behavioral-health codes: the precomputed top 3 Medicaid codes by revenue account for 52.9% of the provider's total Medicaid revenue. Those three codes are 97530 ($42M, 22.6%), 92507 ($40.4M, 21.8%), and 90834 ($15.9M, 8.5%), showing that a majority of Medicaid dollars flow through a narrow set of services.

The code mix points to a pediatric rehabilitation and multidisciplinary therapy operation: heavy revenue and claims for 97530 (238.6K claims, $42M), 97112 (102.6K claims, $9.6M), 97110 (78.5K claims, $6.4M) and speech codes like 92507 (180.4K claims, $40.4M), 92523 ($6.2M) and 92526 ($3.5M) indicate large-scale physical, occupational and speech therapy programs alongside substantial behavioral-health services (90834, 90791). This mix supports an integrated therapy model treating functional, communication, and psychiatric needs in a pediatric specialty setting.

CHILDREN'S SPECIALIZED is a dominant statewide provider for multiple high-volume codes: it ranks #1 in-state for 97530 (100th percentile; extreme outlier), 92507 (100th percentile; extreme outlier), 97112 (100th percentile; extreme outlier), and several OT/PT evaluation and testing codes such as 97165, 97166 and 96137. These top ranks and “extreme outlier” designations indicate the provider operates at volumes far above typical state peers for core rehabilitation and testing services.

Claim volumes demonstrate very high throughput for outpatient therapy and behavioral services—examples include 238.6K claims for 97530, 180.4K claims for 92507, 102.6K claims for 97112 and 84K claims for 90834. Such claim counts, coupled with sizable per‑claim payments (for example $176 avg paid/claim for 97530 and $224 for 92507), point to sustained, high-frequency utilization of therapy visits rather than occasional specialty consults.

The provider also reports substantial evaluation and high-complexity E/M activity, suggesting integrated medical management alongside therapy: 99214 (61.1K claims, $14.7M, 7.9%) and 99215 (35.3K claims, $10.4M, 5.6%) are both high-volume revenue contributors, and 99205 (10.4K claims, $4.8M) ranks #1 in-state. These patterns imply that CHILDREN'S SPECIALIZED pairs intensive therapy services with significant clinician evaluation time for both new and established patients.

Behavioral-health assessment and testing are material parts of the service mix: psychotherapy 90834 accounts for $15.9M (8.5%) and ranks as an extreme outlier (99th percentile), while psychological/neuropsychological testing codes 96137 ($3.8M, rank #1; notably above typical state volume) and 96130/96131 appear as meaningful revenue lines. This combination indicates capacity for diagnostic assessment and ongoing psychotherapeutic care integrated into the rehabilitation program.

The organization has an established operating history with its NPI enumerated on 2007-02-12 (~19 years ago), and the long tenure plus repeated #1 statewide ranks across multiple core codes support a view of CHILDREN'S SPECIALIZED as a long-standing, high-capacity pediatric rehabilitation leader within New Jersey’s Medicaid market.

Medicaid: Complete Services Breakdown

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

105 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.	238,600	$180	$42M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	180,420	$220	$40.4M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	84,010	$190	$15.9M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	61,120	$240	$14.7M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	35,340	$290	$10.4M
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…	102,610	$90	$9.6M
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…	78,530	$80	$6.4M
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	20,040	$310	$6.2M
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	10,430	$460	$4.8M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	11,550	$360	$4.2M

Showing 1–10 of 105

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Children's Specialized Hospital — 20 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

105 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	6	10	14,200	$70	$1.1M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	7	720	1,690	$80	$629.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1	190	860	$100	$534.8K
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	26	30	740	$60	$477.6K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	7	10	14,660	$30	$454.8K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	1	10	360	$320	$406.5K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	2	50	100	$130	$376.6K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	35	330	1,220	$50	$323.4K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	6	10	570	$90	$278.4K
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	1	10	1,880	$150	$273.5K

Showing 1–10 of 105

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Wood Johnson University Hospital, Inc	NJ	General Acute Care Hospital	$0	$198.3M
Saint Peter's University Hospital	NJ	General Acute Care Hospital	$0	$185.5M
Diya Care Inc	NJ	Home Health Agency	$0	$139.8M
Golden Path Adult Day Health Care Inc.	NJ	Adult Day Care Clinic/Center	$0	$17.7M
New Brunswick Board Of Education	NJ	Local Education Agency (LEA)	$0	$12.7M
Care We Love, LLC	NJ	Home Health Agency	$0	$11.2M
Damon House Inc.	NJ	Substance Abuse Rehabilitation Facility	$0	$9.8M
Southern Bank Emergency Physicians LLC	NJ	Emergency Medicine Physician	$0	$9.2M
New Brunswick Counseling Center	NJ	Substance Use Disorder Rehabilitation Clinic/Center	$174.7K	$9M
Rutgers Rwj Eric B. Chandler Health Center	NJ	Federally Qualified Health Center (FQHC)	$0	$7.3M

Children's Specialized Hospital — 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