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

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

Stones Worth Stepping, P.C. (NPI 1861537466)

Key Findings

Field	Value
Entity Type	Organization
Organization	Stones Worth Stepping, P.C.
Address	600 N 93rd St
City	Omaha
State	NE
ZIP	68114
Taxonomy	Occupational Therapist
NPI Enumerated	February 21, 2007

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

STONES WORTH STEPPING, P.C. reports no Medicare billing on file and $4.7M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer (Medicaid) for the periods represented. This payer concentration means all utilization and revenue dynamics described below stem from Medicaid activity rather than a mixed Medicare/Medicaid book of business.

Revenue is highly concentrated in three procedure codes: 97530, 92507, and 97110 together account for 91.4% of this provider’s total Medicaid revenue. The individual contributions to that concentration are visible in the raw code revenues: 97530 generated $2.3M, 92507 generated $1.5M, and 97110 generated $440.3K, indicating these services are the primary business lines.

The code mix points to an operation focused on high‑volume direct therapeutic activities and speech‑language services rather than episodic medical visits: 97530 (37.2K claims, $63 avg paid/claim) is the largest single revenue driver, and 92507 (36.2K claims, $42 avg paid/claim) is nearly equal in claim volume but slightly lower in average payment. 97110 (14.2K claims, $31 avg paid/claim) plays a smaller but still material role, consistent with therapeutic exercise as a supporting service line.

STONES WORTH STEPPING is a major statewide provider for its top behavioral/rehabilitative codes. 97530 ranks #2 of 130 providers in-state (99th percentile; notably above typical state volume) and 92507 ranks #3 of 43 providers in-state (95th percentile; notably above typical state volume), which together signal a dominant position in high-volume therapy and speech services in Nebraska.

Not all high-percentile rankings imply uniformly large dollar impact: 97110 ranks #13 of 213 providers in-state (94th percentile; typical, unremarkable volume) while contributing $440.3K (9.4% of Medicaid revenue), showing the provider’s competitive strength is concentrated in a narrow set of procedures rather than broad-based lead across many CPTs. Other services such as 97112 and 92609 appear as adjunct lines (97112: $194.1K, 92609: $106.5K) that supplement the core 97530/92507 mix.

The provider also reports notable but smaller, specialized speech services: 92609 (3.1K claims, $34 avg paid/claim, $106.5K revenue) ranks #1 of 4 in-state (100th percentile; typical, unremarkable volume), suggesting a niche capability—training patients and caregivers on speech generating devices—that may differentiate clinical offerings despite modest revenue share. This specialty footprint could reflect targeted services not widely offered by peers.

Operationally, the top codes reflect a high‑volume/low‑paid‑per‑claim model: 97530 has 37.2K claims with a $63 avg paid/claim, and 92507 has 36.2K claims with a $42 avg paid/claim, indicating throughput of many short or repeat encounters drives revenue more than high unit pricing. That utilization pattern has implications for billing oversight, staffing mix, and payer contract leverage focused on per‑encounter reimbursement and authorization controls.

The NPI was enumerated 2007-02-21 (~19 years ago), indicating a long tenure in the market which is consistent with the provider’s high in-state rankings and deep claim volumes. For payers and network planners, this tenure plus concentrated Medicaid scale suggests STONES WORTH STEPPING is an established, high‑volume Medicaid therapy vendor whose revenue exposure is sensitive to changes in reimbursement or utilization policy for the few codes that drive 91.4% of its Medicaid revenue.

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
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.	37,170	$60	$2.3M
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…	36,210	$40	$1.5M
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…	14,200	$30	$440.3K
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…	8,440	$20	$194.1K
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.	3,130	$30	$106.5K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	270	$180	$47.3K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	980	$40	$41K
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…	660	$20	$11.3K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	130	$20	$2.3K
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…	20	$50	$1.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Stones Worth Stepping, P.C. — 3 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	3	40	2,880	$40	$386.7K
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.	2	130	650	$40	$179.6K
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…	13	210	660	$40	$122.6K
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…	7	70	480	$30	$89.8K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	4	10	710	$30	$37.2K
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…	18	30	60	$60	$36K
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	10	540	$30	$34K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	4	20	40	$120	$15.9K
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…	1	10	660	$20	$11.6K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	7	10	220	$10	$1.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital & Medical Center	NE	Children's Hospital	$0	$89.8M
Children's Physicians	NE	Pediatrics Physician	$0	$39.4M
Nebraska Pediatric Practice, Inc	NE	Pediatrics Physician	$0	$29M
Physicians Clinic Inc	NE	Family Medicine Physician	$0	$20.5M
Nebraska Methodist Hospital	NE	General Acute Care Hospital	$0	$14.5M
Smiles 4 Kids PC	NE	General Practice Dentistry	$0	$11.5M
Children's Hospital	NE	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$8.4M
Nebraska Methodist Hospital	NE	Emergency Medicine Physician	$0	$5.3M
Unmc College Of Dentistry	NE	Dentist	$0	$4.8M
Pacific Surgery Center, LLC	NE	Ambulatory Surgical Clinic/Center	$3.4M	$3.2K

Stones Worth Stepping, P.C. — Billing Profile & Reimbursement Data

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Stones Worth Stepping, P.C. — 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