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

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

Autism Opportunities Foundation (NPI 1447348172)

Field	Value
Entity Type	Organization
Organization	Autism Opportunities Foundation
Address	5868 Baker Rd
City	Minnetonka
State	MN
ZIP	55345
Taxonomy	Psychologist
NPI Enumerated	October 10, 2006

Payer Source	Total Paid
Medicaid	$97M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only biller: there is no Medicare revenue on file and total Medicaid revenue is $97M, indicating the organization’s financial scale is driven almost entirely by state Medicaid activity. Analysts should treat payer mix as highly concentrated toward Medicaid rather than split across Medicare/Medicaid.

Revenue is heavily concentrated in a very small set of services: the precomputed top three Medicaid codes account for 89.4% of the provider’s Medicaid revenue, led by H2014 at $62.6M (64.6% of Medicaid revenue), followed by 97153 at $17.7M (18.2%), and H0032 at $6.4M (6.6%). This concentration means changes to reimbursement, coverage, or utilization policies for these specific codes would have outsized impact on the provider’s topline.

The code mix and volumes point to an ABA/behavioral therapy–focused operation that delivers large volumes of short, procedure-based visits: H2014 (skills training and development) has 251.5K claims, and 97153 (technician-delivered adaptive behavior treatment) has 152.3K claims. Combined with H0032 (84.3K claims for mental health service plan development by non-physician), the patterns suggest a model built around high-throughput technician-delivered sessions plus centralized non-physician care planning.

Operationally, the provider appears to run high-throughput, per-15-minute service delivery: many top codes (H2014, 97153, 97155, 97154) are reported per 15 minutes and show very large claim counts (e.g., 251.5K for H2014, 152.3K for 97153, 38.9K for 97155). This implies a staffing and scheduling model reliant on many technician-level encounters supervised by qualified clinicians and a workflow that maximizes short-interval billable units.

Competitive standing within Minnesota is dominant for key service lines: H2014 ranks #1 of 185 providers in-state and is labeled an "extreme outlier" at the 100th percentile, and H0032 also ranks #1 of 226 providers at the 100th percentile and is an "extreme outlier." 97153 ranks #3 of 45 providers (95th percentile), indicating very high but not exclusive state volume in technician-delivered adaptive behavior treatment. Together these ranks characterize the provider as a statewide leader in skills training and care-plan development for the relevant population.

The broader service mix includes ancillary and multidisciplinary offerings consistent with comprehensive developmental-disability care: speech-related codes (92507 revenue $1.9M and 92523 revenue $33.1K), assistive-device training (92609 revenue $1.3M, rank #1 of 5), and psychological testing codes (96130/96131/96151 series). These secondary lines suggest the organization provides integrated services beyond pure ABA sessions, increasing its value proposition to Medicaid managed care plans.

Tenure data show the NPI was enumerated on 2006-10-10 (~20 years ago), indicating a long-standing presence in the market. That longevity combined with the scale of Medicaid billing supports the view of an established provider with entrenched clinical and operational processes.

Because the provider lacks Medicare billing and derives the vast majority of revenue from a few Medicaid codes (top three = 89.4%), its financial and operational risk is concentrated: changes in Medicaid fee schedules, program edits, utilization management for H2014/97153/H0032, or state-level policy shifts could materially affect revenue. Analysts should prioritize monitoring Medicaid policy and peer activity around these exact codes when assessing future performance risk.

Medicaid: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2014	Skills training and development, per 15 minutes	251,520	$250	$62.6M
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…	152,350	$120	$17.7M
H0032	Mental health service plan development by non-physician	84,340	$80	$6.4M
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…	38,940	$60	$2.4M
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.	52,290	$40	$1.9M
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…	41,100	$50	$1.9M
92609	The provider performs therapeutic services to enable the patient to make the best use of his speech generating device and also trains the patient’s caregiver.	19,530	$60	$1.3M
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…	27,960	$30	$699K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	25,330	$20	$557.3K
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…	22,950	$20	$436.1K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Autism Opportunities Foundation — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

28 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…	3	50	6,550	$90	$3.1M
H2014	Skills training and development, per 15 minutes	1	190	6,230	$120	$2.2M
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…	5	50	1,140	$70	$720.1K
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…	8	110	1,880	$50	$564.6K
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…	3	10	3,810	$20	$529.3K
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.	7	260	890	$60	$405.3K
92609	The provider performs therapeutic services to enable the patient to make the best use of his speech generating device and also trains the patient’s caregiver.	1	10	320	$60	$309.4K
H0032	Mental health service plan development by non-physician	1	230	490	$80	$255.2K
H0046	Mental health services, not otherwise specified	174	210	2,990	$10	$213.5K
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…	7	20	620	$90	$176.9K

Showing 1–10 of 28

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Memorial Health Care	MN	Primary Care Clinic/Center	$0	$7.4M
Minnetonka Public Schools	MN	Local Education Agency (LEA)	$0	$6.8M
Relate Inc	MN	Community/Behavioral Health Agency	$0	$6.3M
South Lake Clinic, P.A.	MN	Pediatrics Physician	$0	$5.9M
Grand St Paul Cvs LLC	MN	Pharmacy	$84.9K	$0
Amal Wasuge	MN	Occupational Therapist	$77K	$0
Claire Wheatley	MN	Physical Therapist	$56.5K	$0
Maria Ryan	MN	Sports Medicine (Family Medicine) Physician	$40.7K	$0
Andrew Cardinal	MN	Physical Therapist	$30.2K	$0

Autism Opportunities Foundation — Billing Profile & Reimbursement Data

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Autism Opportunities Foundation — 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

Nearby Providers

Frequently Asked Questions

References