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

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

Building Blocks Therapy LLC, (NPI 1780019489)

Building Blocks Therapy LLC, is a community/behavioral health agency provider located in Highland Heights, Ohio. This profile covers 0 Medicare and 9 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	Building Blocks Therapy LLC,
Address	387 Golfview Ln Ste 250
City	Highland Heights
State	OH
ZIP	44143
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 12, 2013

Payer Source	Total Paid
Medicaid	$8.1M
Medicare	$0

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

9 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…	29,670	$220	$6.4M
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…	18,800	$60	$1M
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…	5,370	$40	$209.4K
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…	2,980	$50	$140.2K
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.	3,150	$40	$128.9K
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…	2,250	$40	$81.1K
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…	490	$80	$40.5K
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…	880	$30	$23.9K
97158	The provider administers adaptive behavior treatment to multiple patients in a social skills group. Report this code for each 15 minutes that the provider spends face–to–face with multiple patients…	870	$20	$15.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Building Blocks Therapy LLC, — 4 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

9 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	40	2,980	$230	$1.7M
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…	1	40	990	$120	$317.5K
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…	433	810	2,560	$50	$274.4K
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.	381	1,060	1,850	$30	$126.1K
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…	2	10	2,210	$50	$110.6K
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…	4	20	70	$90	$67.1K
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…	214	490	660	$20	$54K
97158	The provider administers adaptive behavior treatment to multiple patients in a social skills group. Report this code for each 15 minutes that the provider spends face–to–face with multiple patients…	1	10	550	$80	$43.6K
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…	1	20	190	$60	$39K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Traditions Hospice Of Highland Heights, LLC	OH	Community Based Hospice Care Agency	$0	$34M
Medic Home Health Care, LLC	OH	Oxygen Equipment & Supplies (DME)	$0	$17M
Mp Lab Solutions LLC	OH	Clinical Medical Laboratory	$1.1M	$470
David Mandel	OH	Rheumatology Physician	$302.2K	$165.6K
Laura Kwasniak	OH	Dermatology Physician	$299.5K	$0
Anthony Annam	OH	Internal Medicine Physician	$283.1K	$14.1K
Alex Hirsh	OH	Dermatology Physician	$296.1K	$0
Ravi Krishnan	OH	Internal Medicine Physician	$252.4K	$0
Cleveland Asc LLC	OH	Ambulatory Surgical Clinic/Center	$252.3K	$0
Irina Papirova	OH	Internal Medicine Physician	$194.5K	$0

Building Blocks Therapy LLC, — Billing Profile & Reimbursement Data

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Building Blocks Therapy LLC, — 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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References