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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Pediatric Therapy Associates (NPI 1447310958)

Field	Value
Entity Type	Organization
Organization	Pediatric Therapy Associates
Address	2301 Rexwoods Dr Ste 118
City	Raleigh
State	NC
ZIP	27607
Taxonomy	Physical Therapist
NPI Enumerated	December 12, 2006

Payer Source	Total Paid
Medicaid	$10.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	99,040	$60	$5.7M
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.	67,360	$60	$4.1M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	2,520	$60	$156.2K
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…	2,140	$50	$102.8K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	430	$120	$53.4K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	70	$40	$2.6K
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…	20	$50	$870
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…	10	$60	$830
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	20	$40	$620

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Pediatric Therapy Associates — 2 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	16	640	4,280	$60	$983.2K
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.	15	520	2,870	$70	$721.7K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	77	170	1,880	$90	$481.7K
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…	69	290	470	$30	$81.4K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	60	240	120	$130	$51.7K
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…	56	60	50	$50	$12.6K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	43	50	40	$60	$11.8K
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…	46	50	60	$60	$9.3K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	9	20	60	$40	$5.6K

Nearby Providers

Other providers in the same ZIP code as Pediatric Therapy Associates, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Autism Society Of North Carolina, Inc.	NC	Community/Behavioral Health Agency	$0	$95.7M
Rex Hospital Inc.	NC	General Acute Care Hospital	$0	$25.3M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$24.8M
Nc Dept Of Health And Human Service	NC	Clinical Medical Laboratory	$0	$16.4M
Jeffers Mann & Artman Pediatric & Adolesent Medicine PA	NC	Pediatric Adolescent Medicine Physician	$0	$10.9M
Blue Ridge Day Surgery Center, LP	NC	Ambulatory Surgical Clinic/Center	$1.6M	$2.2M
John Thordsen	NC	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Rebecca Manning	NC	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Sachin Mudvari	NC	Retina Specialist (Ophthalmology) Physician	$3.2M	$0
Daniel Bennett	NC	Retina Specialist (Ophthalmology) Physician	$3M	$0

Pediatric Therapy Associates — Billing Profile & Reimbursement Data

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Pediatric Therapy Associates — 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