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

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

Children's Therapy Place, Inc. (NPI 1649281577)

Field	Value
Entity Type	Organization
Organization	Children's Therapy Place, Inc.
Address	101 S Allumbaugh Way
City	Boise
State	ID
ZIP	83709
Taxonomy	Occupational Therapist
NPI Enumerated	August 9, 2006

Payer Source	Total Paid
Medicaid	$30M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-only billing entity: there is no Medicare billing on file and reported lifetime Medicaid revenue is $30M. The NPI was enumerated on 2006-08-09 (~20 years ago), indicating a long-established presence in the market rather than a recent entrant. Analysts should treat Medicaid as the sole payer driving this organization’s revenue profile when modeling exposure or negotiating rates.

Revenue concentration is high: the top 3 Medicaid codes by revenue account for 73.7% of total Medicaid receipts. Those codes are H0004 ($14.3M, 47.7%), 97530 ($4.1M, 13.7%), and 92507 ($3.7M, 12.2%), so nearly three-quarters of all billings are concentrated in these specific behavioral-health and therapy services. This concentration implies that changes in coverage policy, authorization, or unit payment for any of these codes would materially affect the provider’s financials.

The code mix indicates an integrated pediatric behavioral-health and therapy operation: H0004 (behavioral health counseling/therapy), 97530 (therapeutic activities improving functional performance), and 92507 (direct speech-language treatment) together point to a service line combining behavioral counseling, occupational/functional therapy, and speech therapy. The prominence of H2019 (therapeutic behavioral services, $3.2M, 10.6%) and H0032 (mental health service plan development, $571.4K) further supports that the organization delivers both direct therapy and care-planning/behavioral support services. This breadth suggests the provider supports multi-disciplinary care pathways commonly used in pediatric and developmental services.

State-level competitive standing is dominant for multiple high-volume codes: H0004 is ranked #3 of 157 providers in-state (99th percentile; labeled an "extreme outlier"), 97530 is ranked #4 of 282 (99th percentile; extreme outlier), and 92507 is ranked #4 of 210 (99th percentile; extreme outlier). The provider is also the top reporter of H2019 in the state (rank #1 of 60, 100th percentile; extreme outlier). Together these rankings indicate the organization is a major, high-volume statewide player for both behavioral-health counseling and pediatric therapy services rather than a modest or typical provider.

Claim-level utilization shows very high volume for core services: H0004 has 76.5K claims, 97530 has 59.6K claims, and 92507 has 61.1K claims, demonstrating sustained, frequent service delivery rather than occasional episodic care. There are also large counts for psychotherapy and related services (for example, 90834 at 17.1K claims contributing $1.1M), and a notable volume of 90785 add-on claims (14.1K claims) despite a low $4 avg paid/claim; these patterns imply a high-throughput, high-encounter operational model that may rely on many short or repeat service units per patient.

Beyond the top three codes, the provider posts multiple above-typical volumes in care-planning and assessment codes: H0032 is $571.4K (rank #2 of 106, 99th percentile), 96152 is $1.1M (rank #16 of 73, 79th percentile), and 99368 is $84.8K (rank #1 of 7, 100th percentile). This spread indicates capacity for assessment-driven workflows and multidisciplinary meetings, reinforcing that the operation includes both hands-on therapy and formalized evaluation/coordination services. Payers should expect associated utilization of plan development and assessment resources in contracting and utilization management.

For payer contracting and utilization management, this profile signals both opportunity and concentration risk: with $30M in Medicaid revenue and no Medicare revenue, the provider’s financial health and negotiating leverage are tied almost entirely to Medicaid program policies and rates. Given that 73.7% of Medicaid revenue is concentrated in H0004, 97530, and 92507, payers can prioritize review, bundled payment design, or authorization workflows around these codes to influence total spend efficiently. The provider’s high in-state ranks and extreme-outlier status on multiple codes mean any policy change affecting these services will have outsized local impact and should be modeled accordingly.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	76,490	$190	$14.3M
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.	59,560	$70	$4.1M
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…	61,120	$60	$3.7M
H2019	Therapeutic behavioral services, per 15 minutes	29,460	$110	$3.2M
96152	N/A	7,720	$150	$1.1M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	17,050	$60	$1.1M
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…	17,670	$40	$653.9K
H0032	Mental health service plan development by non-physician	4,800	$120	$571.4K
H2015	Comprehensive community support services, per 15 minutes	3,610	$80	$281.2K
T1027	Family training and counseling for child development, per 15 minutes	3,870	$50	$177.9K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Children's Therapy Place, Inc. — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	3	160	4,020	$140	$1.6M
H2014	Skills training and development, per 15 minutes	36	60	2,500	$60	$613.3K
H2019	Therapeutic behavioral services, per 15 minutes	1	60	2,960	$120	$609.8K
96152	N/A	16	70	2,270	$80	$608.8K
H2015	Comprehensive community support services, per 15 minutes	22	50	2,960	$100	$570.3K
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.	4	280	1,480	$70	$389.4K
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…	4	210	3,020	$50	$389K
H0005	Alcohol and/or drug services; group counseling by a clinician	50	80	2,240	$50	$257.3K
T1017	Targeted case management, each 15 minutes	168	190	1,060	$60	$221.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	14	410	740	$60	$174.3K

Showing 1–10 of 31

Nearby Providers

Other providers in the same ZIP code as Children's Therapy Place, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Raise The Bottom Training & Counseling Services, LLC	ID	Addiction (Substance Use Disorder) Counselor	$241.2K	$10.8M
Independent School District Of Boise City	ID	Local Education Agency (LEA)	$0	$7M
Kaleidoscope Pediatric Therapy LLC	ID	Occupational Therapist	$0	$5M
A-1 Home Health Care LLC	ID	Home Health Agency	$0	$4.5M
River City Surgical Center	ID	Ambulatory Surgical Clinic/Center	$0	$4.1M
Hand In Hand LLC	ID	Primary Care Nurse Practitioner	$0	$4.1M
Treasure Valley Pediatric Dentistry	ID	Pediatric Dentistry	$0	$3.2M
Edgewood Spring Creek Overland, LLC	ID	Assisted Living Facility	$0	$2.2M
Sandra Sullivan	ID	Personal Care Attendant	$0	$2.1M
Lifepath Services LLC	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.1M

Children's Therapy Place, Inc. — Billing Profile & Reimbursement Data

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Children's Therapy Place, 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