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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Integral Therapy Center (NPI 1841707635)

Key Findings

Field	Value
Entity Type	Organization
Organization	Integral Therapy Center
Address	Urb Radioville Ave Rafael Colon Castro
City	Arecibo
State	PR
ZIP	00612
Taxonomy	Hearing and Speech Clinic/Center
NPI Enumerated	January 3, 2018

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

INTEGRAL THERAPY CENTER is effectively a Medicaid-focused provider: there is no Medicare billing on file while reported Medicaid revenue totals $3.8M, indicating the organization operates almost entirely within the Medicaid population rather than the Medicare market. This single-payer concentration has implications for payer contracting, reimbursement sensitivity, and revenue stability tied to state Medicaid policies.

Revenue concentration is high: the top three Medicaid codes account for 78.1% of the provider’s total Medicaid revenue, with 92526 ($1.5M, 38.8%) and 92507 ($1.1M, 28.9%) together making up the bulk of that share. This indicates that swallowing/voice and speech assessment/therapy services are the primary revenue drivers and likely the core service lines of the practice.

The code mix points to a specialty practice centered on speech, language, and cognitive/behavioral therapy services: dominant codes 92526 and 92507 are speech-language pathology interventions for swallowing and communication assessments, while high volumes in 97129/97130 and 97130 reflect intensive one-on-one therapeutic cognitive/behavioral intervention sessions. Combined with codes such as 97533 and 97140, the profile suggests a multidisciplinary therapy center delivering frequent, time-based rehabilitative sessions to primarily pediatric and neurodevelopmental populations.

Competitive standing in-state is mixed but includes notable leadership for therapy time codes: the provider ranks #1 of 10 for 97130 and #1 of 14 for 97129 (both 100th percentile), marking it as a dominant outlier in providing billed therapeutic time units for cognitive/therapeutic interventions. By contrast, for major speech codes the provider’s rank is more typical—92526 ranks #3 of 32 (93rd percentile) and 92507 ranks #14 of 141 (91st percentile)—indicating strong but not exclusive market share for swallowing and speech assessment services.

Statistical outliers are present and should inform utilization reviews and capacity planning: 97129 and 97130 are labeled extreme outlier and notably above typical state volume respectively, signaling unusually high volume of billed one-on-one therapy time compared with in-state peers. These labels suggest the provider delivers substantially more timed therapy units per reported period than most competitors, which is operationally consistent with a high-intensity therapy model (e.g., frequent 15-minute units per patient).

Tenure is modest: the NPI was enumerated on 2018-01-03 (~8 years ago), indicating the center has been active long enough to establish referral patterns and billing routines but is not an especially long-standing incumbent compared with many legacy providers. This tenure, combined with concentrated Medicaid revenue, suggests the center’s growth and competitive position were developed primarily within the Medicaid environment over the past decade.

Payer and service-line risk/operational considerations: dependence on a small set of codes for 78.1% of Medicaid revenue concentrates operational risk—any change in Medicaid coverage, unit valuation, or utilization policy for 92526, 92507, or the therapy time codes could materially affect cash flow. Operationally, the provider appears optimized for high-volume, time-based therapy delivery (many 15-minute units), so changes to time-unit billing rules or prior authorization requirements would disproportionately impact this business model.

Broader service breadth beyond the top codes is limited in revenue impact: the rest of the top-25 Medicaid codes each contribute relatively small shares (many under 1% of total Medicaid revenue), which indicates the center’s secondary services—voice/fluency evaluations, occupational therapy evaluations, and some physical/therapeutic modalities—are present but not major revenue drivers. This supports a strategic view of the entity as a focused speech/therapy clinic with supplemental therapy offerings rather than a full multispecialty outpatient practice.

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	24,120	$60	$1.5M
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…	19,950	$60	$1.1M
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	23,280	$20	$395.8K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	23,360	$20	$350.3K
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…	6,860	$40	$253.9K
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…	4,820	$20	$101.1K
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	2,040	$20	$38.8K
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.	4,200	$10	$25.2K
96116	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for the first hour of face–to–face…	300	$70	$19.5K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	80	$160	$12.6K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Puerto Rico Distribution

Integral Therapy Center — 2 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	12	50	1,850	$70	$843.5K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	3	30	1,520	$50	$509.8K
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…	14	140	2,620	$50	$505.7K
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.	9	40	1,150	$40	$135.4K
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	4	10	770	$20	$110.4K
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…	174	180	2,150	$20	$95.2K
97130	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	1	10	1,810	$20	$87.6K
92521	A speech–language pathologist (SLP) evaluates the patient's speech fluency for issues such as stuttering or cluttering.	6	10	110	$90	$77.2K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	1	10	1,040	$20	$60.6K
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…	61	70	950	$20	$60.4K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sociedad De Servicios Neonatales De Arecibo	PR	Neonatal-Perinatal Medicine Physician	$0	$14.3M
Laboratorio Clinico Toledo, LLC	PR	Clinical Medical Laboratory	$83.2K	$11.9M
Metro Pavia At Home, LLC	PR	Home Health Agency	$0	$6.6M
Hospicio La Paz Inc	PR	Community Based Hospice Care Agency	$0	$5.7M
Retina Care Psc	PR	Ophthalmology Physician	$0	$4.3M
Luis Montalvo	PR	Ophthalmology Physician	$8K	$3.5M
Laboratorio Clinico Villa Los Santos	PR	Clinical Medical Laboratory	$360	$3.1M
Emergency Physician Providers, LLC	PR	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.8M
Arraiza Radiology Psc	PR	Diagnostic Radiology Physician	$0	$2.8M
Instituto Del Cancer Y Enfermedades De La Sangre, Csp	PR	Hematology & Oncology Physician	$0	$2.8M

Integral Therapy Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References