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

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

Physical Therapy Services, P.A. (NPI 1831109867)

Physical Therapy Services, P.A. is a clinic/center provider located in Elizabethton, Tennessee. This profile covers 0 Medicare and 13 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	Physical Therapy Services, P.A.
Address	1975 W Elk Ave Ste 1
City	Elizabethton
State	TN
ZIP	37643
Taxonomy	Clinic/Center
NPI Enumerated	August 9, 2006

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

13 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.	31,460	$40	$1.3M
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…	25,100	$30	$803.3K
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…	3,090	$20	$64.9K
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…	1,040	$20	$22.9K
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…	370	$40	$16K
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…	190	$40	$7.7K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	30	$20	$790
97016	In this procedure, the provider applies the vasopneumatic device to an extremity for the purpose of reducing edema, or swelling.	100	$10	$730
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	10	$50	$630
97032	Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…	70	$10	$560

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Physical Therapy Services, P.A. — 0 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	23	340	1,400	$40	$354.2K
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…	20	350	1,060	$30	$173.8K
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…	29	120	610	$10	$81K
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…	64	170	530	$10	$67.8K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	26	30	40	$30	$22.1K
97016	In this procedure, the provider applies the vasopneumatic device to an extremity for the purpose of reducing edema, or swelling.	9	10	230	$10	$21.2K
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…	22	80	90	$40	$18.4K
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…	16	20	50	$30	$16.7K
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…	29	40	380	$10	$11.3K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	28	40	90	$20	$9.8K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Silver Angels Of Tennessee - Carter, LLC	TN	In Home Supportive Care Agency	$0	$19.6M
Medical Care PLLC	TN	Family Medicine Physician	$0	$13.1M
Ocoee Hillview Health Center LLC	TN	Skilled Nursing Facility	$0	$11M
Mountain States Health Alliance	TN	General Acute Care Hospital	$0	$7.2M
Aging In Place, Inc.	TN	Home Health Agency	$0	$4.6M
Carter County Emergency & Rescue Squad, Inc	TN	Land Ambulance	$708.3K	$2.4M
Blue Ridge Medical Management Corporation	TN	Internal Medicine Physician	$0	$2.8M
Med-trans Corporation	TN	Air Ambulance	$353.1K	$253.2K
Alainya Hare	TN	Podiatrist	$49.4K	$33.7K
Michelle Davenport	TN	Internal Medicine Physician	$55.8K	$0

Physical Therapy Services, P.A. — Billing Profile & Reimbursement Data

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Physical Therapy Services, P.A. — 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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Frequently Asked Questions

References