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

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

Autism Advocacy And Intervention, LLC (NPI 1811374440)

Field	Value
Entity Type	Organization
Organization	Autism Advocacy And Intervention, LLC
Address	212 Prouty Dr Ste 2
City	Newport
State	VT
ZIP	05855
Taxonomy	Behavior Analyst
NPI Enumerated	May 4, 2015

Payer Source	Total Paid
Medicaid	$7.8M
Medicare	$0

Key Findings

AUTISM ADVOCACY AND INTERVENTION, LLC reports no Medicare billing on file and $7.8M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) billing entity in the available data. The provider’s NPI was enumerated 2015-05-04 (~11 years ago), indicating an established presence in the market over the past decade.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 96.2% of total Medicaid revenue, driven by H2014 ($6.6M, 84.6%), H0032 ($684.2K, 8.8%), and H2019 ($219.1K, 2.8%). This concentration means a small set of services supplies nearly all of the provider’s billed Medicaid dollars.

Service-line mix and operations are consistent with intensive behavioral and skills-training services: H2014 (Skills training and development, per 15 minutes) is by far the dominant revenue driver and H2019 (Therapeutic behavioral services, per 15 minutes) and H0032 (Mental health service plan development by non-physician) support a focus on adaptive/behavioral treatment and care planning. The code mix suggests the provider operates primarily as an applied behavior analysis/behavioral health service organization delivering repeated session-based skills training and treatment planning.

Competitive standing in-state is strong for the core service H2014 — the provider ranks #1 of 14 providers in-state and sits in the 100th percentile for that code, and the data characterizes its H2014 volume as notably above typical state volume. That ranking indicates market leadership in the state for per-15-minute skills training and development.

H0032 also ranks #1 of 1 providers in-state but is annotated as having no state peer volume comparison available, which denotes that this provider is the sole in-state Medicaid biller for mental health service plan development by a non-physician in the dataset rather than a measured competitive advantage against peers. This makes H0032 an important but non-comparable line item for peer benchmarking.

H2019 is a secondary contributor (2.8% of Medicaid revenue) and ranks #2 of 8 providers in-state at the 86th percentile with a label of typical, unremarkable volume; other mid-tier codes such as H0046 ($163.6K, 2.1%) and S5111 ($106.4K, 1.4%) similarly contribute modest shares under 3% each. These patterns indicate some breadth in behavioral and ancillary mental health services but without the same revenue dominance as H2014.

Several technician and assessment codes show heavy utilization but produce little paid revenue in the file: 97153 has 12K claims with $0 avg paid/claim ($0 revenue), 97155 has 5.5K claims with $0 avg paid/claim ($0 revenue), and 97152 has 438 claims with $0 avg paid/claim ($0 revenue). At the same time, parent/caregiver and assessment codes such as 97156 (3K claims, $1 avg paid/claim, $3K revenue) and 97151 (828 claims, $1 avg paid/claim, $828 revenue) appear billed but yield negligible dollars, suggesting either low unit payment rates or reporting artifacts that separate session volumes from reimbursed professional time.

Operational and payer-mix implication: because the organization derives virtually all reported revenue from Medicaid and is heavily concentrated in H2014 and H0032, its financial performance and capacity are tightly coupled to reimbursement and utilization policies for skills training and non-physician mental health plan development. For payers and competitors evaluating this entity, expect a specialized provider focused on repeated-session behavioral training with market-leading volume in H2014 within Vermont.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2014	Skills training and development, per 15 minutes	40,510	$160	$6.6M
H0032	Mental health service plan development by non-physician	470	$1,470	$684.2K
H2019	Therapeutic behavioral services, per 15 minutes	1,800	$120	$219.1K
H0046	Mental health services, not otherwise specified	1,440	$110	$163.6K
S5111	Home care training, family; per session	1,090	$100	$106.4K
A0425	Ground mileage, per statute mile	7,160	$1	$14.3K
T1014	Telehealth transmission, per minute, professional services bill separately	260	$20	$4K
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…	3,030	$1	$3K
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…	830	$1	$830
97152	A technician, supervised by a physician or other qualified healthcare professional, provides supporting assessment of a patient’s destructive behavior and behavioral problems by interacting directly…	440	$0	$0

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Autism Advocacy And Intervention, LLC — 2 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0046	Mental health services, not otherwise specified	3	10	330	$1,360	$3.1M
H0032	Mental health service plan development by non-physician	1	10	470	$1,470	$684.2K
H2014	Skills training and development, per 15 minutes	1	10	7,770	$60	$599.6K
A0425	Ground mileage, per statute mile	9	60	1,570	$50	$160.5K
S5111	Home care training, family; per session	1	10	690	$80	$54.6K
H2019	Therapeutic behavioral services, per 15 minutes	2	10	260	$50	$34.1K
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…	1	10	1,220	$10	$24.1K
T1014	Telehealth transmission, per minute, professional services bill separately	1	10	260	$20	$4.1K
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	10	440	$1	$2.8K
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	10	3,030	$1	$1.6K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Autism Advocacy And Intervention, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Kingdom Human Services Inc Ds Waiver	VT	Developmental Disabilities Clinic/Center	$0	$204.7M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$85.8K	$17.6M
Northeast Kingdom Human Services Inc Sbs	VT	Adolescent and Children Mental Health Clinic/Center	$0	$8.3M
Newport Ambulance Service Inc.	VT	Land Ambulance	$743.2K	$2.9M
North Country Hospital & Health Center Inc	VT	Internal Medicine Physician	$0	$3.2M
North East Kingdom Community Action, Inc.	VT	Public Health or Welfare Agency	$0	$2.8M
Northeast Kingdom Human Services Inc Mh Children	VT	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
North Country Hospital & Health Center Inc	VT	Pediatrics Physician	$0	$2.2M
James V. Wyllie, Dds P.C.	VT	General Practice Dentistry	$0	$1.8M
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$1.7M

Autism Advocacy And Intervention, LLC — Billing Profile & Reimbursement Data

Sign up for Autism Advocacy And Intervention, LLC — Billing Profile & Reimbursement Data policy alerts

Autism Advocacy And Intervention, LLC — Billing Profile & Reimbursement Data

Sign up for Autism Advocacy And Intervention, LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References