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

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

The Spaulding Rehabilitation Hospital Corporation (NPI 1780600825)

The Spaulding Rehabilitation Hospital Corporation is a rehabilitation hospital provider located in Charlestown, Massachusetts. This profile covers 0 Medicare and 72 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	The Spaulding Rehabilitation Hospital Corporation
Address	300 1st Ave
City	Charlestown
State	MA
ZIP	02129
Taxonomy	Rehabilitation Hospital
NPI Enumerated	July 14, 2006

Payer Source	Total Paid
Medicaid	$54.8M
Medicare	$0

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

72 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…	220,730	$70	$14.3M
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…	60,320	$160	$9.9M
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.	80,950	$90	$7.3M
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…	99,050	$50	$4.5M
J0585	Injection, onabotulinumtoxina, 1 unit	4,680	$890	$4.2M
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…	23,890	$140	$3.2M
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…	38,650	$60	$2.5M
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	5,790	$170	$990.6K
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…	19,020	$50	$989K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	15,450	$60	$988.7K

Showing 1–10 of 72

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

The Spaulding Rehabilitation Hospital Corporation — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

72 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	37	110	5,660	$30	$1.1M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	25	410	140	$110	$742.2K
J0585	Injection, onabotulinumtoxina, 1 unit	2	40	430	$490	$616K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,566	1,620	580	$80	$599.6K
92607	The provider evaluates the patient for prescription of a speech–generating device. This code represents the first or only hour. The provider interacts with the patient, conducts various tests, and…	2	10	2,740	$120	$328.6K
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	290	980	$70	$240.4K
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…	2	750	930	$40	$231.2K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	27	90	170	$260	$193.6K
J0475	Injection, baclofen, 10 mg	2	10	190	$370	$157.1K
J3490	Unclassified drugs	51	90	740	$30	$128.8K

Showing 1–10 of 72

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adult Day Health, Inc.	MA	Adult Day Care Clinic/Center	$0	$13.4M
Melissa Colbert	MA	Physical Medicine & Rehabilitation Physician	$242.1K	$0
Michelle Kenny	MA	Family Medicine Physician	$188K	$0
Scott Homer	MA	Physical Medicine & Rehabilitation Physician	$127.7K	$0
M Arnaout	MA	Nephrology Physician	$45.6K	$0
Chloe Slocum	MA	Spinal Cord Injury Medicine Physician	$43.3K	$0
Miguel Rivera	MA	Molecular Genetic Pathology (Medical Genetics) Physician	$3.8K	$0

The Spaulding Rehabilitation Hospital Corporation — Billing Profile & Reimbursement Data

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The Spaulding Rehabilitation Hospital Corporation — 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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