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

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

Actualize Behavior Alternatives (NPI 1902251705)

Field	Value
Entity Type	Organization
Organization	Actualize Behavior Alternatives
Address	5575 S Sycamore St Ste 108
City	Littleton
State	CO
ZIP	80120
Taxonomy	Clinical Social Worker
NPI Enumerated	April 29, 2016

Payer Source	Total Paid
Medicaid	$6.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	880	$3,680	$3.2M
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…	780	$2,630	$2.1M
H2019	Therapeutic behavioral services, per 15 minutes	2,500	$310	$770K
H0046	Mental health services, not otherwise specified	110	$3,260	$349.2K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	30	$610	$18.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Actualize Behavior Alternatives — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	101	150	2,450	$270	$1.5M
H2019	Therapeutic behavioral services, per 15 minutes	36	100	1,090	$90	$600.8K
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…	78	150	800	$210	$457.9K
H0046	Mental health services, not otherwise specified	53	60	1,380	$140	$397.2K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	23	30	70	$160	$23.9K

Nearby Providers

Other providers in the same ZIP code as Actualize Behavior Alternatives, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integrated Life Choices	CO	Developmentally Disabled Services Day Training Agency	$0	$123.6M
Caps - Mental Health And Dui Services, LLC	CO	Community/Behavioral Health Agency	$0	$6.8M
Andy M. Fine, M.d., Inc	CO	Internal Medicine Physician	$0	$3.8M
Rocky Mountain Health & Rehab, LLC	CO	Physical Therapist	$0	$3.5M
Manojkumar Bupathi	CO	Hematology & Oncology Physician	$1.4M	$0
Functional Neurosurgical Ambulatory Surgery Center,llc	CO	Ambulatory Surgical Clinic/Center	$955.9K	$0
Arapahoe Surgicenter, LLC	CO	Ambulatory Surgical Clinic/Center	$452K	$353.4K
Charles Leonard	CO	Radiation Oncology Physician	$495.5K	$0
Littleton Day Surgery Center LLC	CO	Ambulatory Surgical Clinic/Center	$384.3K	$0
Marie Weeks	CO	Radiation Oncology Physician	$355.2K	$0

Actualize Behavior Alternatives — Billing Profile & Reimbursement Data

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Actualize Behavior Alternatives — Billing Profile & Reimbursement Data

Sign up for Actualize Behavior Alternatives — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References