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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Autism Management Group (NPI 1912280405)

Field	Value
Entity Type	Organization
Organization	Autism Management Group
Address	4552 Route 152
City	Lavalette
State	WV
ZIP	25535
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 21, 2011

Payer Source	Total Paid
Medicaid	$3.7M
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
S5125	Attendant care services; per 15 minutes	2,270	$1,450	$3.3M
T2021	Day habilitation, waiver; per 15 minutes	1,540	$220	$332.9K
T1016	Case management, each 15 minutes	1,130	$70	$79.2K
A0160	Non-emergency transportation: per mile - case worker or social worker	130	$190	$23.9K
T1002	Rn services, up to 15 minutes	180	$80	$13.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Autism Management Group — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	42	40	14,820	$750	$30.5M
T2021	Day habilitation, waiver; per 15 minutes	46	60	6,490	$120	$2.2M
T1016	Case management, each 15 minutes	64	100	2,790	$90	$496.2K
A0160	Non-emergency transportation: per mile - case worker or social worker	100	110	2,030	$50	$278.8K
T1002	Rn services, up to 15 minutes	134	150	1,980	$40	$232.6K

Nearby Providers

Other providers in the same ZIP code as Autism Management Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainstream Services, Incorporated	WV	Case Management Agency	$0	$14.1M

Autism Management Group — Billing Profile & Reimbursement Data

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Autism Management Group — 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