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.

Special Kids Inc (NPI 1851328082)

Field	Value
Entity Type	Organization
Organization	Special Kids Inc
Address	2208 East Main Street
City	Murfreesboro
State	TN
ZIP	37130
Taxonomy	Physical Therapist
NPI Enumerated	June 26, 2006

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 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.	40,160	$60	$2.3M
T2027	Specialized childcare, waiver; per 15 minutes	11,030	$190	$2.1M
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…	36,230	$50	$1.7M
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	1,640	$40	$62.2K
96154	N/A	620	$30	$18K
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…	280	$50	$13.9K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	120	$100	$11.1K
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…	10	$60	$820

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

Special Kids Inc — 1 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2027	Specialized childcare, waiver; per 15 minutes	1	10	11,030	$190	$2.1M
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…	15	230	2,130	$40	$616.8K
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.	18	340	1,400	$40	$354.2K
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…	66	80	3,450	$20	$181.5K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	16	60	540	$50	$63K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	24	60	70	$110	$28.3K
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…	70	80	90	$40	$18.4K
96154	N/A	2	10	280	$20	$7.5K

Nearby Providers

Other providers in the same ZIP code as Special Kids Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Rutherford Office Of Budget Director	TN	Land Ambulance	$2.3M	$8M
Mckee, Curry, Stanley, Pediatric Dentistry Partnership	TN	Pediatric Dentistry	$0	$6.3M
Hemal Mehta	TN	Physical Medicine & Rehabilitation Physician	$4.5M	$5K
Center For Excellence	TN	Adult Mental Health Clinic/Center	$0	$3.9M
Ronald Nelson	TN	Dermatology Physician	$336K	$0
James Garner	TN	Internal Medicine Physician	$166.3K	$0
Nicholas Dieringer	TN	Internal Medicine Physician	$127.6K	$1.1K
Joseph Weathersby	TN	Physician Assistant	$96.6K	$0
Charles Goodman	TN	Dermatology Physician	$95.8K	$0
Beckmans Prescription Shop	TN	Durable Medical Equipment & Medical Supplies	$90.5K	$0

Special Kids Inc — Billing Profile & Reimbursement Data

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Special Kids Inc — 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