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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Pediatric Developmental Therapy (NPI 1730137779)

Pediatric Developmental Therapy is a speech-language pathologist provider located in Fayetteville, North Carolina. This profile covers 0 Medicare and 14 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	Pediatric Developmental Therapy
Address	1289 Oliver St
City	Fayetteville
State	NC
ZIP	28304
Taxonomy	Speech-Language Pathologist
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicaid	$12.1M
Medicare	$0

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

14 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…	93,730	$60	$5.8M
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.	64,480	$60	$3.7M
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…	28,380	$40	$1.1M
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…	27,260	$40	$954.1K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	3,110	$140	$438.1K
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…	4,270	$20	$89.6K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	360	$30	$10K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	180	$30	$4.9K
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…	90	$50	$4.3K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	60	$60	$3.4K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Pediatric Developmental Therapy — 5 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

14 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…	20	640	4,280	$60	$983.2K
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.	19	520	2,870	$70	$721.7K
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	140	450	$30	$91.2K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	57	60	440	$60	$84K
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…	4	290	470	$30	$81.4K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	4	240	120	$130	$51.7K
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…	5	50	470	$10	$25.7K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	27	60	170	$10	$18.2K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	10	30	280	$30	$18K
97161	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…	38	60	50	$50	$12.6K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cumberland County Hospital System Inc	NC	General Acute Care Hospital	$0	$75.8M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$32.8M
Valleygate Dental Surgery Center Of Fayetteville, LLC	NC	Ambulatory Surgical Clinic/Center	$0	$26.5M
Cfvhs Ed Physicians	NC	Emergency Medicine Physician	$0	$26.2M
Rafael Rivera, Jr., Dds, PLLC	NC	Dentist	$0	$14.2M
Cumberland County Hospital System Inc	NC	Internal Medicine Physician	$0	$8M
Calvary Pediatrics	NC	Pediatrics Physician	$0	$7.8M
Children's Health Of Carolina, PA	NC	Pediatrics Physician	$0	$7.6M
Chauncy Nelson	NC	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$7.4M
Fayetteville Ambulatory Surgery Center LLC	NC	Ambulatory Surgical Clinic/Center	$1.4M	$2.2M

Pediatric Developmental Therapy — Billing Profile & Reimbursement Data

Sign up for Pediatric Developmental Therapy — Billing Profile & Reimbursement Data policy alerts

Pediatric Developmental Therapy — Billing Profile & Reimbursement Data

Sign up for Pediatric Developmental Therapy — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References