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

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

Behavior Interventions, Inc (NPI 1518190669)

Field	Value
Entity Type	Organization
Organization	Behavior Interventions, Inc
Address	2500 Renaissance Blvd Ste 170
City	King Of Prussia
State	PA
ZIP	19406
Taxonomy	Behavior Analyst
NPI Enumerated	August 24, 2009

Payer Source	Total Paid
Medicaid	$73.7M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only operation: there is no Medicare billing on file and lifetime Medicaid revenue is $73.7M, so all documented programmatic scale and financial footprint come from Medicaid activity. That payer concentration makes Medicaid reimbursement policy and state-level managed care relationships the primary commercial levers affecting this entity.

Revenue is highly concentrated in a narrow set of service codes: the precomputed top three Medicaid codes account for 92.9% of this provider’s total Medicaid revenue. That concentration indicates the business is functionally specialized around a small number of service lines rather than a broad basket of behavioral health or habilitation services.

The code mix—dominated by 97153, 97155, and 97151—signals an operation built around applied behavior analysis (ABA) services with heavy technician-delivered treatment plus supervisory and evaluative components. 97153 (technician-delivered adaptive behavior treatment), 97155 (supervising professional modifying/treating while teaching a technician), and 97151 (assessment, scoring, reporting and care-plan development) together define a service model that emphasizes high-volume, face-to-face ABA treatment sessions supported by professional oversight.

97153 is the single largest revenue driver: 221.2K claims at $193 avg paid/claim produced $42.7M in revenue (57.9% of this provider’s Medicaid revenue). That scale and the per-claim rate indicate the provider’s throughput is concentrated in technician-delivered direct treatment, consistent with a high-volume outpatient ABA delivery model.

Supervisor-level and assessment services are also material: 97155 generated 82.2K claims at $232 avg paid/claim for $19.1M (25.9%), while 97151 produced 46.9K claims at $144 avg paid/claim for $6.7M (9.2%). These volumes show the organization bills substantial professional time for protocol modification, oversight, and formal assessments in addition to technician hours, implying a layered staffing model with measurable clinical oversight.

On competitive standing within Pennsylvania this provider is a dominant statewide player for its core ABA codes: 97153, 97155, and 97151 all rank #1 in-state and are described as 100th percentile, extreme outliers, far above typical state volume for these codes. Those rankings indicate the provider operates at a scale for ABA services that substantially exceeds typical in-state peers and positions it as a market leader for these specific service lines.

Secondary codes generate only modest revenue and suggest some service breadth but limited impact on overall revenue mix: H0046 ($867.3K; rank #33 of 173), H2021 ($724.4K; rank #83 of 218), H2016 ($605.5K; rank #1 of 3 but described as typical/unremarkable), T2021 ($399.3K; rank #4 of 4), and H0032 ($42.2K; rank #167 of 209). These non-ABA codes together account for small shares of revenue and appear to be ancillary to the provider’s core ABA business.

The provider’s NPI has been enumerated since 2009-08-24 (~17 years ago), indicating an established presence in the market; when combined with very large claim volumes (e.g., 221.2K claims for 97153) this tenure supports the interpretation that the organization has built significant operational capacity to deliver and bill high-volume outpatient ABA services.

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
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…	221,150	$190	$42.7M
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…	82,180	$230	$19.1M
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	46,860	$140	$6.7M
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…	18,220	$140	$2.6M
H0046	Mental health services, not otherwise specified	6,830	$130	$867.3K
H2021	Community-based wrap-around services, per 15 minutes	7,390	$100	$724.4K
H2016	Comprehensive community support services, per diem	1,020	$590	$605.5K
T2021	Day habilitation, waiver; per 15 minutes	1,010	$400	$399.3K
H0032	Mental health service plan development by non-physician	440	$100	$42.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Behavior Interventions, Inc — 5 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

9 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…	1	150	8,280	$220	$4.1M
H2021	Community-based wrap-around services, per 15 minutes	83	220	3,810	$100	$1.5M
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…	1	150	2,770	$200	$1.4M
H0032	Mental health service plan development by non-physician	167	210	3,020	$130	$1.3M
T2021	Day habilitation, waiver; per 15 minutes	4	10	8,530	$110	$911.2K
H0046	Mental health services, not otherwise specified	33	170	1,200	$130	$909.6K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	1	120	1,330	$180	$557.5K
H2016	Comprehensive community support services, per diem	1	10	890	$530	$412.2K
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…	1	100	530	$120	$196.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Promptcare Companies, Inc.	PA	Oxygen Equipment & Supplies (DME)	$0	$78.5M
Children's Hospital Of Philadelphia	PA	Durable Medical Equipment & Medical Supplies	$0	$27.6M
Cnnh Therapy LLC	PA	Behavior Analyst	$0	$26.2M
Children's Hospital Of Philadelphia	PA	Home Infusion Agency	$0	$23.1M
Helping Hands Family Pennsylvania LLC	PA	Community/Behavioral Health Agency	$0	$15.8M
Trustees Of The University Of Pennsylvania	PA	Home Infusion Agency	$159.1K	$7.2M
Ambulnz PA, LLC	PA	Ambulance	$3.3M	$3.8M
Quality Life Healthcare LLC	PA	Nursing Care Agency	$0	$6.3M
Wal-mart Stores, Inc.	PA	Optician	$0	$5.7M
Main Line Spine Surgery Center, LLC	PA	Ambulatory Surgical Clinic/Center	$3.8M	$0

Behavior Interventions, Inc — Billing Profile & Reimbursement Data

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Behavior Interventions, Inc — 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