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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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 Princecare Group (NPI 1831316595)

Field	Value
Entity Type	Organization
Organization	The Princecare Group
Address	1520 Baxter Ave
City	Louisville
State	KY
ZIP	40205
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	April 20, 2007

Payer Source	Total Paid
Medicaid	$19M
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5100	Day care services, adult; per 15 minutes	73,590	$80	$5.8M
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.	57,680	$60	$3.6M
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…	72,210	$40	$3.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	16,090	$170	$2.7M
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.	29,170	$60	$1.6M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	9,220	$50	$442.6K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	8,070	$50	$419.6K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	8,370	$50	$385.1K
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…	10,800	$40	$378K
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…	7,040	$30	$176.1K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

The Princecare Group — 5 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	59	310	830	$120	$3.7M
S5100	Day care services, adult; per 15 minutes	10	100	16,270	$70	$1.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	25	180	1,320	$220	$1.9M
T2021	Day habilitation, waiver; per 15 minutes	136	150	16,130	$70	$1.7M
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…	5	340	2,730	$40	$328.2K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	4	30	860	$70	$241.4K
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.	5	540	1,500	$50	$235.7K
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…	103	780	1,950	$30	$157.8K
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.	1	20	490	$60	$134.8K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	100	170	12,280	$10	$107.5K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as The Princecare Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dreams With Wings, Inc	KY	Behavior Analyst	$0	$20.1M
Hosparus Inc.	KY	Community Based Hospice Care Agency	$0	$10.1M
Dental Surgicenter Of Louisville LLC	KY	Ambulatory Surgical Clinic/Center	$0	$8.4M
Thomas Stone	KY	Retina Specialist (Ophthalmology) Physician	$2.5M	$520
Norton Hospitals Inc	KY	Land Ambulance	$791.2K	$77.1K
Andrew West	KY	MOHS-Micrographic Surgery Physician	$713.9K	$0
Tariq Muhammad	KY	Nephrology Physician	$245.5K	$189K
Casey Johnson	KY	Ophthalmology Physician	$284.1K	$0
Ramsey Nassar	KY	Nephrology Physician	$253.9K	$0
Boutros El-haddad	KY	Nephrology Physician	$247.3K	$0

The Princecare Group — Billing Profile & Reimbursement Data

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The Princecare Group — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References