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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Hospital For Sick Children (NPI 1689656183)

Hospital For Sick Children is a special hospital provider located in Washington, District of Columbia. This profile covers 0 Medicare and 21 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	Hospital For Sick Children
Address	1731 Bunker Hill Rd Ne
City	Washington
State	DC
ZIP	20017
Taxonomy	Special Hospital
NPI Enumerated	November 18, 2005

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

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
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.	11,020	$120	$1.3M
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…	7,990	$150	$1.2M
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.	3,020	$170	$526K
97755	In this procedure, the provider performs an assessment of a patient with a disability to decide the best assistive technology. Assistive technology devices are devices that assist a patient who has a…	3,450	$110	$382.7K
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…	2,330	$110	$256.2K
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…	2,470	$90	$217.4K
97760	In this service, the provider trains a patient on the use of an orthotic device on the upper extremity, lower extremity, and/or trunk. He may also assess and adjust the fit for the device. In…	2,060	$90	$189.3K
97763	At a subsequent encounter after the initial encounter, the provider meets face–to–face with the patient to manage or train the patient on the use of an upper or lower extremity or trunk orthotic or…	1,880	$100	$180.7K
97542	In this procedure, the provider assesses the patient’s need for a wheelchair and teaches him wheelchair maneuvering skills.	1,450	$80	$117.3K
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…	920	$110	$101.3K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Hospital For Sick Children — 3 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	19	30	3,790	$110	$1.4M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	55	130	290	$140	$579.2K
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.	7	40	1,100	$70	$527.5K
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.	1	10	3,020	$170	$525K
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…	6	30	1,170	$130	$489K
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…	14	20	1,760	$50	$433.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	87	120	1,050	$110	$409.5K
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…	10	20	2,330	$50	$372.3K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	10	10	530	$80	$359.2K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	128	320	620	$50	$313.6K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
My Own Place, Inc.	DC	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$48.7M
Anchor Mental Health Association	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22M
Hsc Home Care, LLC	DC	Home Health Agency	$0	$14.7M
Providence Health Services Inc	DC	Family Medicine Physician	$0	$13.4M
Providence Hospital	DC	General Acute Care Hospital	$0	$12.2M
American Health Care Services Inc	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.3M
United Cerebral Palsy Of Washington & No. Virginia, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$4.4M
Gerald Family Care	DC	Family Medicine Physician	$0	$3.2M
Cheryl Lee	DC	Dentist	$0	$2.5M
Providence Opticians Designer Eyewear Inc	DC	Eyewear Supplier	$0	$2.1M

Hospital For Sick Children — Billing Profile & Reimbursement Data

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Hospital For Sick Children — 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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