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

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

Therapy Management Services, LLC. (NPI 1952414005)

Field	Value
Entity Type	Organization
Organization	Therapy Management Services, LLC.
Address	4201 Spring Valley Rd Ste 600
City	Dallas
State	TX
ZIP	75244
Taxonomy	Home Health Agency
NPI Enumerated	August 15, 2006

Payer Source	Total Paid
Medicaid	$76.2M
Medicare	$0

Key Findings

THERAPY MANAGEMENT SERVICES, LLC. is effectively a Medicaid-focused provider with $76.2M in lifetime Medicaid revenue and no Medicare billing on file; the record explicitly shows “none below” for Medicare, so this entity operates as essentially single-payer (Medicaid) at scale in Texas. The absence of Medicare revenue makes it sensitive to Medicaid policy and rate changes as its primary source of reimbursement.

Revenue is highly concentrated: the precomputed top three Medicaid codes (92507, 97530, 97110) account for 94.8% of this provider’s total Medicaid revenue, with 92507 alone representing 70.6% ($53.8M), 97530 representing 14.8% ($11.3M), and 97110 representing 9.4% ($7.1M). This concentration indicates that a very small group of therapy CPT/HCPCS codes drives nearly all of the reported Medicaid dollars.

The code mix points to a service-line profile dominated by speech-language pathology and high-volume rehabilitative therapy delivered in direct-contact settings: 92507 (speech treatment) is by far the largest revenue driver, supported by large volumes on 97530 (therapeutic activities) and 97110 (therapeutic exercise). High claim counts for those codes (578.4K claims for 92507, 117.9K for 97530, 76.9K for 97110) suggest a volume-driven care model that relies on repeat, time-based therapy units rather than occasional high-dollar procedures.

On competitive standing within Texas, the provider is a clear outlier for multiple codes: 92507 ranks #1 of 1354 providers (100th percentile; extreme outlier), 97530 ranks #2 of 1616 (100th percentile; extreme outlier), and 97110 ranks #3 of 1319 (100th percentile; extreme outlier). These ranks indicate a dominant statewide position for the primary service lines and volumes that are far above typical state peers for those codes.

Beyond the top three, the provider bills a range of related therapy and evaluation codes that reflect breadth across speech, occupational, and physical therapy services; examples include 92523 ($1.3M, 1.7%), S9152 ($1.2M, 1.6%), 97167 ($234.8K, 0.3%), and 97168 ($206.2K, 0.3%). Several of these secondary codes also carry extreme outlier labels or very high percentiles (e.g., 92523 and S9152 are both 100th percentile; extreme outlier), which reinforces that the operation is a comprehensive, high-volume therapy provider rather than a narrow specialty shop.

Unit payment levels are consistent across the top revenue codes, with avg paid/claim near the mid-two-digit to low-three-digit range ($93 for 92507, $96 for 97530, $93 for 97110), indicating that the provider’s revenue model is driven primarily by very large service volumes rather than elevated per-unit reimbursement. This pattern—similar per-unit payments coupled with extreme claim volumes—underscores volume as the principal lever for revenue growth and explains the concentration noted above.

The heavy reliance on a few high-volume, time- or service-unit therapy codes creates material operational and reimbursement exposure: because 94.8% of Medicaid revenue is tied to 92507, 97530, and 97110, any policy, prior-authorization, or rate-change targeting these therapy codes could materially affect total Medicaid revenue. Analysts should flag this concentration as a potential single-point sensitivity when modeling payer mix or projecting revenue under policy scenarios.

The provider’s NPI was enumerated on 2006-08-15 (~20 years ago), indicating long tenure in the market; combined with $76.2M in Medicaid revenue and repeated top-state rankings, this suggests an established, high-capacity therapy operation with sustained presence in Texas Medicaid networks.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	578,390	$90	$53.8M
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.	117,850	$100	$11.3M
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…	76,860	$90	$7.1M
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	8,740	$150	$1.3M
S9152	Speech therapy, re-evaluation	10,890	$110	$1.2M
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	2,890	$130	$361.3K
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	900	$380	$340.2K
97167	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of high analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	2,300	$100	$234.8K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	2,150	$100	$206.2K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	1,480	$100	$144.6K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Therapy Management Services, LLC. — 8 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	132	140	29,740	$490	$24.4M
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…	1	1,350	1,860	$80	$872.4K
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	1,620	1,070	$70	$333.5K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	29	120	450	$100	$304.6K
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…	3	1,320	1,070	$60	$211.1K
S9152	Speech therapy, re-evaluation	1	270	120	$110	$62.5K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	1	360	100	$140	$62K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	5	180	90	$90	$29.4K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	8	110	90	$90	$26.5K
97167	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of high analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	1	60	40	$100	$22.1K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Therapy Management Services, LLC., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gentech Laboratories LLC	TX	Clinical Medical Laboratory	$3.3M	$91.8M
Awh Financial Services LLC	TX	Supports Brokerage Agency	$0	$34M
Signify Health, LLC	TX	General Practice Physician	$0	$12.7M
Signify Health Medical Associates, PLLC	TX	General Practice Physician	$0	$11.3M
Concepta Labs, LLC	TX	Clinical Medical Laboratory	$2.4M	$47.3K
Dedrick Ahmed	TX	Optometrist	$260.4K	$0
Daniel Shropshire	TX	Optometrist	$223.7K	$1.7K
Carlos Marquez De La Plata	TX	Clinical Neuropsychologist	$143.2K	$0
Omali Diagnostics LLC	TX	Clinical Medical Laboratory	$101.6K	$1.7K
Christina Roberts	TX	Family Nurse Practitioner	$67.4K	$0

Therapy Management Services, LLC. — Billing Profile & Reimbursement Data

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Therapy Management Services, LLC. — Billing Profile & Reimbursement Data

Sign up for Therapy Management Services, LLC. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References