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.

Carolina Therapy Connection, PC (NPI 1609187178)

Carolina Therapy Connection, PC is a pediatric occupational therapist provider located in Greenville, North Carolina. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Carolina Therapy Connection, PC
Address	1925a Turnbury Dr
City	Greenville
State	NC
ZIP	27858
Taxonomy	Pediatric Occupational Therapist
NPI Enumerated	June 29, 2010

Payer Source	Total Paid
Medicaid	$12.5M
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	77,640	$80	$6.4M
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…	85,340	$60	$5.4M
T2025	Waiver services; not otherwise specified (nos)	4,880	$100	$463.6K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	1,620	$140	$231.4K
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…	1,130	$30	$38.4K
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	360	$60	$20.2K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	450	$30	$12.6K
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…	170	$60	$10K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	190	$20	$4.6K
97116	The provider instructs the patient in the proper ways of practicing various exercises, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without…	30	$30	$960

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

Carolina Therapy Connection, PC — 2 of 10 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

10 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…	27	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.	10	520	2,870	$70	$721.7K
T2025	Waiver services; not otherwise specified (nos)	20	80	1,420	$170	$562K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	68	140	450	$30	$91.2K
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…	104	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.	17	240	120	$130	$51.7K
97116	The provider instructs the patient in the proper ways of practicing various exercises, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without…	43	50	470	$10	$25.7K
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…	13	60	50	$50	$12.6K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	43	80	210	$10	$12.4K
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	6	40	30	$40	$7.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pride In North Carolina, LLC	NC	Community/Behavioral Health Agency	$0	$98.2M
Pinnacle Home Care, Inc.	NC	Developmentally Disabled Services Day Training Agency	$0	$59.3M
East Carolina University	NC	Internal Medicine Physician	$0	$53.7M
Easter Seals Ucp Nc & Va, Inc.	NC	Community/Behavioral Health Agency	$0	$38.8M
Maxim Healthcare Services, Inc.	NC	Home Health Agency	$0	$35M
Pathways To Life, Inc	NC	Community/Behavioral Health Agency	$0	$30.4M
Behavioral Framework Nc LLC	NC	Behavior Analyst	$0	$29.4M
Venture Rehabilitation Group	NC	Speech-Language Pathologist	$0	$16M
At Home Personal Care Services,inc. Of North Carolina	NC	Home Health Agency	$0	$14.5M
East Carolina Home Care	NC	In Home Supportive Care Agency	$0	$14.5M

Carolina Therapy Connection, PC — Billing Profile & Reimbursement Data

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Carolina Therapy Connection, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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