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

Why is the Medicaid comparison limited to South 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. South 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.

Therapy World (NPI 1770091670)

Field	Value
Entity Type	Organization
Organization	Therapy World
Address	1038 Shorthill Ln
City	Fort Mill
State	SC
ZIP	29715
Taxonomy	Occupational Therapist
NPI Enumerated	January 14, 2018

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 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.	21,660	$80	$1.6M
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…	8,790	$60	$527.3K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	310	$120	$37.1K
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…	290	$50	$14.2K
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…	90	$30	$3K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	80	$20	$1.9K
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…	10	$80	$1000
92522	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns. The jaw, lips, and tongue are examined for proper…	10	$50	$620

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Therapy World — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

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

8 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…	89	340	2,970	$80	$711.1K
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.	33	350	2,590	$70	$550.2K
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…	81	90	170	$20	$25.3K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	13	70	30	$100	$20.7K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	24	30	480	$10	$18.9K
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…	7	30	70	$20	$8.1K
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…	27	50	110	$30	$7.7K
92522	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns. The jaw, lips, and tongue are examined for proper…	5	10	10	$50	$2.7K

Nearby Providers

Other providers in the same ZIP code as Therapy World, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fort Mill School District #4	SC	Local Education Agency (LEA)	$0	$5.5M
Carolinas Physicians Network Inc	SC	Pediatrics Physician	$0	$3M
Barrett Little	SC	Orthopaedic Surgery Physician	$170.5K	$3.2K
Christopher Jones	SC	Otolaryngology Physician	$140.1K	$0
Sunitha Sequeira	SC	Otolaryngology Physician	$113K	$0
David Macknet	SC	Orthopaedic Surgery Physician	$86K	$0
Michael Roberts	SC	Physician Assistant	$82.7K	$0
Benjamin Sutker	SC	Orthopaedic Hand Surgery Physician	$80K	$0
South Carolina Cvs Pharmacy LLC	SD	Pharmacy	$76.9K	$0
Kevin Mccullough	SC	Physician Assistant	$35K	$0

Therapy World — Billing Profile & Reimbursement Data

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Therapy World — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References