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.

Applied Behavioral Advancements, LLC (NPI 1851510374)

Field	Value
Entity Type	Organization
Organization	Applied Behavioral Advancements, LLC
Address	196 Observation Pointe Dr
City	Somerset
State	KY
ZIP	42503
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	April 24, 2007

Payer Source	Total Paid
Medicaid	$29.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	170,680	$160	$27.1M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	6,010	$120	$733.3K
H0023	Alcohol and/or drug outreach	13,130	$30	$433.2K
S9128	Speech therapy, in the home, per diem	3,460	$80	$280.3K
S9129	Occupational therapy, in the home, per diem	3,370	$80	$279.6K
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…	1,510	$130	$192K
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	60	$810	$47.6K
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…	450	$90	$40.9K
96152	N/A	10	$670	$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…	20	$50	$1.1K

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

Applied Behavioral Advancements, LLC — 2 of 10 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

10 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.	72	310	830	$120	$3.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	1	180	1,320	$220	$1.9M
S9128	Speech therapy, in the home, per diem	20	30	8,300	$70	$1.7M
S9129	Occupational therapy, in the home, per diem	20	30	7,220	$70	$1.1M
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…	20	40	1,770	$150	$567.9K
H0023	Alcohol and/or drug outreach	5	20	1,570	$50	$454.8K
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…	22	30	910	$130	$217.1K
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	1	10	30	$470	$14.2K
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…	7	10	30	$40	$6.7K
96152	N/A	4	10	20	$220	$4.3K

Nearby Providers

Other providers in the same ZIP code as Applied Behavioral Advancements, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Morrland Healthcare LLC	KY	Community/Behavioral Health Agency	$0	$54.8M
Protea Behavioral Health Counseling, PLLC	KY	Professional Counselor	$0	$24.4M
Lake Cumberland Regional Hospital, LLC	KY	Internal Medicine Physician	$0	$15.6M
Cumberland Behavior Group, LLC	KY	Community/Behavioral Health Agency	$0	$15.2M
Quest Counseling	KY	Mental Health Counselor	$0	$12.5M
Lake Cumberland Recovery, Inc	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.8M
Achievements Through Actions	KY	Developmentally Disabled Services Day Training Agency	$0	$10M
Lake Cumberland Surgery Center LP	KY	Ambulatory Surgical Clinic/Center	$1M	$8.7M
Adult Day Health, Inc.	KY	Adult Day Care Clinic/Center	$0	$8.9M
Infinite Abilities & Supports, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.9M

Applied Behavioral Advancements, LLC — Billing Profile & Reimbursement Data

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Applied Behavioral Advancements, LLC — 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