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

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

Michigan State University (NPI 1427443274)

Field	Value
Entity Type	Organization
Organization	Michigan State University
Address	325 W Grand River Ave
City	East Lansing
State	MI
ZIP	48823
Taxonomy	Behavior Analyst
NPI Enumerated	March 30, 2015

Payer Source	Total Paid
Medicaid	$5.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	20,640	$180	$3.8M
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…	3,190	$290	$935K
0365T	Adaptive behavior tx addl	1,790	$340	$606K
0369T	Duodenal mucosal resurfacing, endoscopic	1,260	$70	$87.2K
97154	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	7,910	$10	$87K
0368T	Behavior treatment modified additional	1,280	$60	$75.3K
0364T	Behavior treatment	1,790	$30	$46.6K
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…	70	$110	$7.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Michigan State University — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	51	130	11,590	$190	$7.6M
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…	64	130	3,170	$180	$2.2M
0365T	Adaptive behavior tx addl	51	70	3,180	$170	$1.5M
0369T	Duodenal mucosal resurfacing, endoscopic	20	70	740	$160	$299.1K
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…	91	100	910	$90	$283.6K
0364T	Behavior treatment	50	70	2,990	$30	$231.4K
0368T	Behavior treatment modified additional	25	70	900	$60	$131K
97154	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	5	10	3,610	$20	$123.2K

Nearby Providers

Other providers in the same ZIP code as Michigan State University, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cypress Home Care, Inc.	MI	Home Health Agency	$0	$9.1M
Pine Hollow Partner LLC	MI	Nurse Practitioner	$0	$7.1M
Edward W. Sparrow Hospital Association	MI	Urgent Care Clinic/Center	$0	$5.4M
Ahmed El-sanhouri	MI	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
O'neil Biscette	MI	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Ashim Aggarwal	MI	Ophthalmology Physician	$1.3M	$0
Michigan Surgical Center,llc	MI	Ambulatory Surgical Clinic/Center	$1.1M	$157.2K
Richard Pittsley	MI	Rheumatology Physician	$765.8K	$0
Julia Hobson	MI	Diagnostic Radiology Physician	$367.1K	$0
Scott Piette	MI	Glaucoma Specialist (Ophthalmology) Physician	$341.9K	$0

Michigan State University — Billing Profile & Reimbursement Data

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Michigan State University — 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