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

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

Missoula Pediatric Therapy Center Inc (NPI 1891263034)

Field	Value
Entity Type	Organization
Organization	Missoula Pediatric Therapy Center Inc
Address	2321 S 3rd St W
City	Missoula
State	MT
ZIP	59801
Taxonomy	Occupational Therapist
NPI Enumerated	November 6, 2018

Payer Source	Total Paid
Medicaid	$848.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 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.	4,470	$100	$438K
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…	7,580	$50	$409.5K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	20	$80	$1.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Missoula Pediatric Therapy Center Inc — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

3 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…	29	150	2,760	$40	$224.3K
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.	44	200	1,110	$60	$207.2K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	8	10	70	$10	$1.5K

Nearby Providers

Other providers in the same ZIP code as Missoula Pediatric Therapy Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Montana Mental Health Center	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$87.8M
Opportunity Resources Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$48.5M
Missoula Developmental Service Corp	MT	Non-emergency Medical Transport (VAN)	$0	$33.6M
Express Personnel Services	MT	Nursing Care Agency	$0	$20.4M
3 Rivers Mental Health Solutions LLC	MT	Community/Behavioral Health Agency	$0	$16.7M
Missoula County Public Schools	MT	Local Education Agency (LEA)	$0	$16.3M
Meadowlark Home Care LLC	MT	Home Health Agency	$0	$12.9M
Client Dedicated Services, Inc	MT	Home Health Agency	$0	$10.6M
Children's Dentistry Of The Rockies	MT	Pediatric Dentistry	$0	$10.1M
Missoula Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.3M

Missoula Pediatric Therapy Center Inc — Billing Profile & Reimbursement Data

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Missoula Pediatric Therapy Center 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