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

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

Aba Programming Inc. (NPI 1770706160)

Key Findings

Field	Value
Entity Type	Organization
Organization	Aba Programming Inc.
Address	7901 E 88th St
City	Indianapolis
State	IN
ZIP	46256
Taxonomy	Medical Specialty Clinic/Center
NPI Enumerated	April 11, 2007

Payer Source	Total Paid
Medicaid	$54.7M
Medicare	$0

ABA PROGRAMMING INC. is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and the entity reported $54.7M in lifetime Medicaid revenue, indicating the practice’s scale and payer dependency are concentrated in state Medicaid programs. This payer concentration should be considered when modeling revenue risk or contract negotiations.

Revenue is highly concentrated in a very small number of services: the precomputed top‑3 Medicaid codes account for 96.8% of the provider’s total Medicaid revenue, driven primarily by 97153 (75.6%), followed by 97155 (15.4%) and 96152 (5.8%). That concentration suggests the business’s financial performance is tightly tied to policy and reimbursement stability for a narrow set of codes.

The code mix and descriptions indicate an ABA‑centered operation with a heavy emphasis on technician‑delivered services and structured supervisory/provider involvement: 97153 is a technician‑administered adaptive behavior treatment code, while 97155 documents the qualified provider’s face‑to‑face adaptive behavior treatment and protocol modification; 96152 appears as an adjunct assessment/diagnostic code supporting that therapy model. Together these codes point to a high‑volume applied behavior analysis service line with supervisory oversight rather than a broad multidisciplinary clinic.

Competitive standing for the primary service is strong within the state. 97153 ranks #3 of 96 providers in‑state and sits in the 98th percentile with labeling of “notably above typical state volume,” indicating ABA PROGRAMMING INC. is a major statewide provider of technician‑administered adaptive behavior treatment. 97155 and 96152 also rank highly (#5 of 84 and #3 of 43, both 95th percentile) but are described as having “typical, unremarkable volume,” suggesting the provider’s dominance is most pronounced for technician sessions.

The payment profile is skewed toward high per‑claim reimbursements for the lead service: 97153 has 97.2K claims with a $425 avg paid/claim yielding $41.3M in revenue, while 97155 recorded 33.2K claims at $254 avg paid/claim ($8.4M) and 96152 recorded 17.4K claims at $182 avg paid/claim ($3.2M). This gulf in avg paid/claim and absolute revenue underscores that technician sessions (97153) are both the volume and payment driver for the practice.

Although the operation is highly concentrated in ABA codes, a small set of ancillary therapy codes appear with modest revenue shares: 97530 ($611.9K, 1.1%), 92507 ($351.7K, 0.6%), and 97154 ($295.1K, 0.5%) are present but together represent a very small fraction of total Medicaid revenue. That distribution suggests the provider offers limited ancillary rehabilitation or speech services relative to its ABA core.

Claim volumes confirm a large‑scale, high‑throughput therapy model: the provider filed 97.2K claims for 97153, 33.2K claims for 97155, and 17.4K claims for 96152, which implies substantial consistent session delivery and likely a sizable technician workforce to support face‑to‑face sessions. These volumes align with the provider’s dominant ranking for its lead code and reinforce its operational focus on frequent, short‑interval therapy encounters.

ABA PROGRAMMING INC. has an established presence with an NPI enumeration date of 2007-04-11 (~19 years ago), indicating long tenure in the market; combined with the high rankings and heavy Medicaid revenue reliance, this suggests an entrenched niche provider of Medicaid‑funded ABA services in Indianapolis and statewide.

Medicaid: Complete Services Breakdown

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

16 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…	97,250	$430	$41.3M
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…	33,210	$250	$8.4M
96152	N/A	17,360	$180	$3.2M
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.	13,020	$50	$611.9K
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…	13,030	$30	$351.7K
97154	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	4,040	$70	$295.1K
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…	1,340	$200	$271.6K
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.	3,050	$40	$106.7K
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…	2,850	$40	$105.5K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	110	$100	$10.7K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Aba Programming Inc. — 4 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	3	100	3,740	$430	$7.7M
96152	N/A	3	40	720	$200	$1.1M
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…	5	80	1,360	$150	$1M
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…	81	390	3,600	$50	$511.6K
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.	38	400	1,100	$40	$382.2K
96151	N/A	9	20	1,080	$70	$361.8K
97154	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	6	10	3,370	$40	$219.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	438	520	240	$80	$165K
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…	7	30	520	$140	$135.1K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	22	50	80	$70	$70.1K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Physicians Of Indiana Inc	IN	Family Medicine Physician	$0	$185M
Medical Associates	IN	Emergency Medicine Physician	$0	$50M
Community Health Network, Inc	IN	General Acute Care Hospital	$0	$32.9M
Radiology Of Indiana P C	IN	Diagnostic Radiology Physician	$0	$22.3M
Fairbanks Hospital, Inc.	IN	Psychiatric Hospital	$0	$18.5M
Virag	IN	Clinic/Center	$7.7M	$610
North Campus Surgery Center LLC	IN	Ambulatory Surgical Clinic/Center	$1.3M	$0
Darrel Ross	IN	Radiation Oncology Physician	$870.5K	$0
Kristi George	IN	Neurology Physician	$688.9K	$0
Lorraine Calvert	IN	Adult Health Nurse Practitioner	$484.2K	$0

Aba Programming Inc. — 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