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

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

Vermont Sports Medicine Center (NPI 1730103300)

Vermont Sports Medicine Center is a occupational therapist provider located in Rutland, Vermont. 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	Vermont Sports Medicine Center
Address	5 Albert Cree Dr
City	Rutland
State	VT
ZIP	05701
Taxonomy	Occupational Therapist
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$1.1M
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
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…	19,140	$30	$612.5K
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…	15,290	$30	$443.3K
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…	700	$40	$25.3K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	370	$50	$18.7K
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.	90	$50	$4.4K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	170	$10	$1.6K
97162	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…	10	$80	$980
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	20	$10	$190
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	50	$0	$0
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	490	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Vermont Sports Medicine Center — 3 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	30	40	370	$90	$133.5K
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…	1	60	390	$40	$56.1K
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…	1	50	340	$30	$49.7K
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…	8	40	200	$30	$15.9K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	1	10	30	$50	$7.7K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	2	10	60	$10	$4.5K
97162	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…	1	10	10	$70	$970
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	1	10	20	$10	$180
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	2	10	520	$0	$0
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	2	10	120	$0	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Mainolfi	VT	Physical Therapist	$54.2K	$0
Gina Courcelle	VT	Physical Therapist	$45.1K	$0
Shannon Mcbride	VT	Physical Therapist	$43.9K	$0
Ashleigh Raub	VT	Physical Therapist	$41.3K	$0
Erin Gordon	VT	Physical Therapist	$33.4K	$0
Jennifer Thomas	VT	Physical Therapist	$21.3K	$0
Rebecca Turner	VT	Hand Occupational Therapist	$17.9K	$1.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Mental Health Services	VT	Developmental Disabilities Clinic/Center	$0	$122.1M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$20.6M
Rutland Mental Health Services, Inc.	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.7M
Rutland Hospital, Inc.	VT	Psychiatric Hospital Unit	$396.2K	$13.3M
Community Health Centers Of The Rutland Region, Inc.	VT	Pediatrics Physician	$0	$13.6M
Regional Ambulance Service, Inc	VT	Land Ambulance	$1.4M	$5.3M
Vna & Hospice Of The Southwest Region, Inc	VT	Home Health Agency	$0	$4.8M
Bradford Psychiatric Associates. LLC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$4.7M
Community Health Centers Of The Rutland Region, Inc.	VT	Dentist	$0	$4.4M
Community Health Centers Of The Rutland Region, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.3M

Vermont Sports Medicine Center — Billing Profile & Reimbursement Data

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Vermont Sports Medicine Center — 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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