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

Why is the Medicaid comparison limited to Virginia 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. Virginia (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 Behavior Therapy (NPI 1467845115)

Field	Value
Entity Type	Organization
Organization	Autism Behavior Therapy
Address	5750 Drake Ct
City	Alexandria
State	VA
ZIP	22311
Taxonomy	Behavior Analyst
NPI Enumerated	March 5, 2015

Payer Source	Total Paid
Medicaid	$9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2033	Multisystemic therapy for juveniles, per 15 minutes	29,390	$230	$6.7M
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…	4,950	$400	$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…	750	$320	$235.3K
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…	320	$190	$59.2K
H0032	Mental health service plan development by non-physician	30	$10	$270

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Autism Behavior Therapy — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2033	Multisystemic therapy for juveniles, per 15 minutes	16	80	5,390	$210	$3.8M
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…	43	90	4,220	$210	$1.6M
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…	52	90	1,030	$260	$977.2K
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…	26	50	320	$160	$164.1K
H0032	Mental health service plan development by non-physician	177	240	100	$70	$32.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Alexandria	VA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$29.7M
Vinni Juneja	VA	Hematology & Oncology Physician	$1M	$0
Jonathan Segal	VA	Cardiovascular Disease Physician	$632.2K	$13.6K
David Bray	VA	Dermatology Physician	$326K	$0
Robert Herscowitz	VA	Pulmonary Disease Physician	$227.6K	$0
Leila Youssef	VA	Internal Medicine Physician	$169.6K	$0
Rajesh Gupta	VA	Neurology Physician	$156K	$0
Ramsey Falconer	VA	Neurology Physician	$151.4K	$0
Juliette Wohlrab	VA	Pulmonary Disease Physician	$150.5K	$0
Lewis Eberly	VA	Neurology Physician	$147.3K	$0

Autism Behavior Therapy — Billing Profile & Reimbursement Data

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Autism Behavior Therapy — Billing Profile & Reimbursement Data

Sign up for Autism Behavior Therapy — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References