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

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

Caravel Autism Health, LLC (NPI 1588993091)

Key Findings

Field	Value
Entity Type	Organization
Organization	Caravel Autism Health, LLC
Address	1575 Allouez Ave
City	Green Bay
State	WI
ZIP	54311
Taxonomy	Behavior Analyst
NPI Enumerated	December 11, 2009

Payer Source	Total Paid
Medicaid	$18.5M
Medicare	$0

This provider is effectively single‑payer in scale: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $18.5M, and the NPI was enumerated 2009-12-11 (~17 years ago), indicating long operational tenure focused on Medicaid-reimbursed services. The absence of Medicare activity combined with a long enumeration date suggests the organization’s business model and client base are concentrated in child/adolescent or Medicaid-covered behavioral health populations rather than fee‑for‑service Medicare beneficiaries.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 90.1% of this provider's total Medicaid revenue. Those top drivers are 97153 ($13M revenue (70.3% of this provider's total Medicaid revenue)), 97155 ($2.9M revenue (15.5% of this provider's total Medicaid revenue)), and H0032 ($798.1K revenue (4.3% of this provider's total Medicaid revenue)), indicating that a very large share of Medicaid dollars come from adaptive behavior treatment and related plan development.

The code mix signals an ABA‑centric service line with a hierarchical staffing model: large volumes of 97153 (technician-delivered adaptive behavior treatment) and 97155 (provider-delivered/modification of behavior plans) show the operation relies on high technician face‑to‑face time with supervisory/clinician oversight. H0032 (mental health service plan development by non‑physician) further supports that care coordination and care‑plan documentation are billed services, consistent with a behavior‑analytic clinic model.

Operational scale and unit economics are visible in claim counts and average payments: 97153 shows 128.6K claims at $101 avg paid/claim ($13M revenue (70.3% of this provider's total Medicaid revenue)) and 97155 shows 36.6K claims at $78 avg paid/claim ($2.9M revenue (15.5% of this provider's total Medicaid revenue)). These volumes plus the reported averages indicate the business generates revenue primarily through frequent, short‑interval technician sessions supervised by qualified clinicians.

State-level competitive standing is strong for core ABA codes. The provider ranks #2 of 114 for 97153 (99th percentile; typical, unremarkable volume) and #2 of 107 for 97155 (99th percentile; notably above typical state volume), which positions it as one of the larger in‑state suppliers of adaptive behavior treatment. H0032 ranks #1 of 3 (100th percentile; typical, unremarkable volume), reflecting leadership in billed plan‑development among the few providers using that code at scale.

The practice also bills significant evaluation and testing services well above peers: 96131 (5.1K claims, $81 avg paid/claim, $414.6K revenue (2.2% of this provider's total Medicaid revenue)) ranks #1 of 25 (100th percentile; extreme outlier) and 96130 (4.4K claims, $72 avg paid/claim, $319.8K revenue (1.7% of this provider's total Medicaid revenue)) ranks #1 of 31 (100th percentile; extreme outlier). 90791 (4.5K claims, $85 avg paid/claim, $382.3K revenue (2.1% of this provider's total Medicaid revenue)) ranks #3 of 369 (99th percentile; extreme outlier), collectively indicating unusually high volumes of diagnostic evaluation and testing relative to in‑state peers.

The provider shows multiple statistically notable usages beyond core therapy: codes tied to testing and scoring (96136, 96137, 96139, 96138) and caregiver/provider consultation (97156: 3.6K claims, $47 avg paid/claim, $167.6K revenue (0.9% of this provider's total Medicaid revenue) — ranks #4 of 76 providers in-state (96th percentile; typical, unremarkable volume)) indicate a diversified billing mix that includes formal assessments and family training. Several of these codes are ranked in high percentiles (for example, 96136 ranks #3 of 32, 94th percentile; notably above typical state volume), reinforcing that the organization bills both therapy and intensive assessment/consultation services.

Concentration risk is material given reliance on a few procedure codes: 97153 alone accounts for $13M (70.3%) and the top three codes together account for 90.1% of Medicaid revenue. Payers and network analysts should note that reimbursement policy changes, utilization management, or rate adjustments affecting 97153/97155/H0032 would disproportionately impact this provider’s revenue base.

Medicaid: Complete Services Breakdown

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

21 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…	128,640	$100	$13M
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…	36,630	$80	$2.9M
H0032	Mental health service plan development by non-physician	13,080	$60	$798.1K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	5,120	$80	$414.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	4,500	$90	$382.3K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	4,440	$70	$319.8K
96139	A technician administers two or more psychological or neuropsychological tests and scores them requiring an additional 30 minutes beyond the initial 30 minutes.	1,480	$170	$245.2K
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…	3,570	$50	$167.6K
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…	570	$140	$82.2K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	2,330	$30	$70K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Caravel Autism Health, LLC — 7 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

21 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…	2	110	5,170	$80	$1.5M
T2017	Habilitation, residential, waiver; 15 minutes	22	30	820	$110	$605.6K
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…	2	110	2,070	$120	$581.8K
T2037	Therapeutic camping, day, waiver; each session	16	20	200	$500	$420.2K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	45	50	670	$120	$361.8K
H0032	Mental health service plan development by non-physician	1	10	80	$60	$268K
96139	A technician administers two or more psychological or neuropsychological tests and scores them requiring an additional 30 minutes beyond the initial 30 minutes.	3	30	320	$110	$66K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	1	30	130	$120	$65.4K
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…	4	80	200	$70	$60.4K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	1	30	110	$70	$38.5K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baycare Aurora, LLC	WI	General Acute Care Hospital	$0	$25.4M
County Of Brown	WI	Clinic/Center	$0	$21.1M
County Of Brown	WI	Community/Behavioral Health Agency	$0	$8.2M
Visiting Nurse Association Of Wisconsin, Inc.	WI	Home Infusion Therapy Pharmacy	$0	$5M
Baycare Clinic LLP	WI	Emergency Medicine Physician	$0	$3.6M
County Of Brown	WI	Case Management Agency	$0	$3.3M
Aegis Group Inc	WI	Land Ambulance	$1.2M	$1.6M
Visiting Nurse Association Of Wisconsin, Inc	WI	Home Health Agency	$0	$2.7M
Orthopedic Surgery Center Of Green Bay, LLC	WI	Ambulatory Surgical Clinic/Center	$2M	$0
Debbie Lim	WI	Rheumatology Physician	$1.8M	$0

Caravel Autism Health, LLC — Billing Profile & Reimbursement Data

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Caravel Autism Health, LLC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Lund	WI	Clinical Psychologist	$0	$77.1M
Victoria Oliversen	WI	Behavior Analyst	$0	$1.3M