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

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

Center For Autism And Related Disorders LLC (NPI 1669651675)

Field	Value
Entity Type	Organization
Organization	Center For Autism And Related Disorders LLC
Address	5850 Granite Pkwy Ste 600
City	Plano
State	TX
ZIP	75024
Taxonomy	Behavior Analyst
NPI Enumerated	October 25, 2007

Payer Source	Total Paid
Medicaid	$73M
Medicare	$0

Key Findings

CENTER FOR AUTISM AND RELATED DISORDERS LLC is effectively a single-payer Medicaid provider: there is no Medicare billing on file while lifetime Medicaid revenue is $73M, indicating the organization’s scale and financial footprint are driven almost entirely by Medicaid programs. This makes the entity a state-market–focused operator rather than a mixed Medicare/Medicaid provider.

Revenue is highly concentrated in a few procedure lines: the top three Medicaid codes (97153, H2019, 0365T) account for 82.0% of the provider’s total Medicaid revenue. Specifically, 97153 accounts for $34.1M (46.8%), H2019 for $18.8M (25.7%), and 0365T for $6.9M (9.5%), together forming the bulk of billed services and payments.

The code mix and descriptions indicate a core business model centered on applied behavior analysis (ABA) and technician-delivered adaptive behavior treatment: 97153 (technician-delivered adaptive behavior treatment), 97155 (supervisory adaptive behavior treatment), and 0365T (adaptive behavior add-on) are among the largest revenue drivers. This pattern—large volumes of technician face-to-face time combined with supervisory and assessment codes—is consistent with a high-throughput ABA service operation that bills both direct technician time and associated supervisory/assessment services.

CENTER FOR AUTISM AND RELATED DISORDERS holds a dominant competitive standing in Texas for ABA-related Medicaid services: 97153 and H2019 both rank #1 in-state at the 100th percentile and are labeled as "extreme outlier" volumes, and 97155 also ranks #1 of 31 providers (100th percentile). These rank and percentile signals indicate the provider operates far above typical state volumes for its leading service lines and is a major statewide participant for those codes.

Claim volumes support the characterization of very high service throughput: 97153 shows 266.8K claims and H2019 shows 210.8K claims, with 0365T at 54.2K claims and 97155 at 53.2K claims. Such sustained, large claim counts suggest substantial caseload capacity and consistent delivery of time-based ABA services rather than sporadic or occasional use of these codes.

Beyond the three biggest codes, the provider bills a range of assessment and caregiver-focused services that broaden its service footprint: H0032 ($2.4M), H0046 ($1.9M), 97151 ($684.8K), 97156 ($455K), and home-training codes S5111 and S5110 are all present, indicating active involvement in care-plan development, formal assessments, caregiver training, and family guidance in addition to direct treatment. This mix signals integrated delivery of assessment, planning, direct therapy, and caregiver support within the Medicaid scope.

Several codes show limited or unique state peer comparisons, which highlights both specialized offerings and measurement gaps: 0365T, 0364T, 0369T and others rank #1 of 1 or show a 0th percentile/no state peer comparison available, meaning the provider bills services that few or no other in-state peers report. At the same time, multiple high-volume codes are explicitly labeled as "extreme outlier" or "notably above typical state volume," reinforcing that the provider’s scale is atypical relative to state peers.

The provider has a long-tenure NPI (enumerated 2007-10-25, ~19 years), which aligns with the sustained high-volume Medicaid billing profile observed. That longevity supports the interpretation that the organization has established operational processes and payer relationships that underlie its dominant state-level position in ABA-related Medicaid services.

Medicaid: Complete Services Breakdown

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

19 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…	266,760	$130	$34.1M
H2019	Therapeutic behavioral services, per 15 minutes	210,770	$90	$18.8M
0365T	Adaptive behavior tx addl	54,170	$130	$6.9M
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…	53,200	$90	$4.6M
H0032	Mental health service plan development by non-physician	66,500	$40	$2.4M
H0046	Mental health services, not otherwise specified	19,070	$100	$1.9M
H2033	Multisystemic therapy for juveniles, per 15 minutes	3,780	$250	$926.1K
0364T	Behavior treatment	52,640	$20	$894.8K
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…	4,450	$150	$684.8K
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…	6,320	$70	$455K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Center For Autism And Related Disorders LLC — 10 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0365T	Adaptive behavior tx addl	1	10	54,170	$130	$6.9M
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	40	1,710	$130	$1.2M
H0046	Mental health services, not otherwise specified	1	10	9,570	$100	$944.7K
H2033	Multisystemic therapy for juveniles, per 15 minutes	1	10	3,780	$250	$927.4K
0364T	Behavior treatment	1	10	52,640	$20	$881.9K
H2012	Behavioral health day treatment, per hour	4	10	5,980	$120	$875.6K
H0032	Mental health service plan development by non-physician	1	10	170	$50	$759K
H2019	Therapeutic behavioral services, per 15 minutes	1	160	1,030	$100	$322.9K
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	30	490	$100	$264.4K
0369T	Duodenal mucosal resurfacing, endoscopic	1	10	2,650	$70	$178.9K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Center For Autism And Related Disorders LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Health System Of Texas	TX	Children's Hospital	$0	$65.8M
Nys Home Health, LLC	TX	Home Health Agency	$0	$11.1M
Delta Laboratories LLC	TX	Clinical Medical Laboratory	$4.7M	$690.5K
Joel Lurie	TX	Nurse Practitioner	$2.8M	$0
Hemang Pandya	TX	Retina Specialist (Ophthalmology) Physician	$1.1M	$0
Matthew Adams	TX	Retina Specialist (Ophthalmology) Physician	$873.3K	$0
Medi-lynx Cardiac Monitoring LLC	TX	Physiological Laboratory	$4.4K	$741.4K
Andrew Binder	TX	Cardiovascular Disease Physician	$677.6K	$0
Jose Rivera	TX	Cardiovascular Disease Physician	$646.5K	$0
Hao-yu Ren	TX	Cardiovascular Disease Physician	$546.6K	$0

Center For Autism And Related Disorders LLC — Billing Profile & Reimbursement Data

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Center For Autism And Related Disorders 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

Nearby Providers

Frequently Asked Questions

References