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

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

Speech Pathology Services Of East Tennessee LLC (NPI 1659466712)

Speech Pathology Services Of East Tennessee LLC is a rehabilitation clinic/center provider located in Maryville, Tennessee. This profile covers 0 Medicare and 13 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	Speech Pathology Services Of East Tennessee LLC
Address	2030 Chilhowee Medical Park
City	Maryville
State	TN
ZIP	37804
Taxonomy	Rehabilitation Clinic/Center
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$9.3M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	186,410	$40	$6.5M
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.	63,400	$40	$2.3M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	20,920	$10	$167.4K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	7,430	$20	$163.5K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	140	$110	$15K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	270	$50	$13.5K
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…	330	$40	$11.7K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	80	$40	$3.2K
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…	60	$50	$3K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	70	$40	$2.8K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Speech Pathology Services Of East Tennessee LLC — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

13 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…	3	230	2,130	$40	$616.8K
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.	9	340	1,400	$40	$354.2K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	26	80	3,450	$20	$181.5K
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…	242	350	1,060	$30	$173.8K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	22	60	70	$110	$28.3K
92609	The provider performs therapeutic services to enable the patient to make the best use of his speech generating device and also trains the patient’s caregiver.	10	10	300	$30	$27.2K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	55	60	470	$10	$23.6K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	12	30	40	$30	$22.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	6	440	90	$10	$17.1K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	9	20	50	$30	$16.7K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
App Of Tennessee Ed, PLLC	TN	Emergency Medicine Physician	$0	$30.3M
Prisma Health - Blount Memorial Hospital Inc.	TN	General Acute Care Hospital	$0	$14.8M
East Tennessee Oral & Maxillofacial Surgery, PC	TN	Oral and Maxillofacial Surgery (Dentist)	$0	$7.1M
East Tennessee Addiction Specialists	TN	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.5M
Open Hearts Open Arms	TN	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$4.8M
Foothills Pediatric Dentristry, P.C.	TN	Pediatric Dentistry	$0	$2.2M
Maryville Asc	TN	Ambulatory Surgical Clinic/Center	$350.4K	$141.2K
Molecular Pathology Laboratory Network Inc	TN	Clinical Medical Laboratory	$369.4K	$60.8K
Donna Brantley	TN	Family Nurse Practitioner	$263.1K	$0
Robert Ivy	TN	Orthopaedic Hand Surgery Physician	$231.7K	$0

Speech Pathology Services Of East Tennessee LLC — Billing Profile & Reimbursement Data

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Speech Pathology Services Of East Tennessee LLC — 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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