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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 Systems LLC (NPI 1972030724)

Field	Value
Entity Type	Organization
Organization	Autism Systems LLC
Address	3245 Keewahdin Rd
City	Fort Gratiot
State	MI
ZIP	48059
Taxonomy	Behavior Analyst
NPI Enumerated	May 11, 2017

Payer Source	Total Paid
Medicaid	$26.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 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…	92,530	$190	$17.5M
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…	30,670	$230	$7.1M
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…	1,760	$360	$636K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	6,560	$80	$551.4K
0365T	Adaptive behavior tx addl	3,170	$140	$427.8K
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.	2,340	$60	$135.7K
0369T	Duodenal mucosal resurfacing, endoscopic	870	$140	$117.3K
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…	880	$130	$116.9K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	1,940	$50	$98.7K
0364T	Behavior treatment	3,090	$30	$86.6K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Autism Systems LLC — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

14 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…	9	130	11,590	$190	$7.6M
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…	11	130	3,170	$180	$2.2M
T1005	Respite care services, up to 15 minutes	106	110	4,910	$80	$2.2M
0365T	Adaptive behavior tx addl	37	70	3,180	$170	$1.5M
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…	104	160	2,030	$60	$407.6K
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…	9	60	200	$380	$398.1K
0369T	Duodenal mucosal resurfacing, endoscopic	32	70	740	$160	$299.1K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	9	100	910	$90	$283.6K
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.	168	390	1,660	$40	$281.8K
S0215	Non-emergency transportation; mileage, per mile	29	110	2,100	$30	$250.8K

Showing 1–10 of 14

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Innovative Housing Development Corp	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$46.9M
Region Vii Area Agency On Aging Inc	MI	PACE Provider Organization	$0	$43.5M
Newco Ambulatory Surgery Center, LLP	MI	Ambulatory Surgical Clinic/Center	$808.3K	$0
Omar Turk	MI	Neurology Physician	$241.8K	$0
Richard Kovar	MI	Neurology Physician	$80.8K	$0
Ahmad Alabbas	MI	Internal Medicine Physician	$44.9K	$27.2K
Anthony Bianchi	MI	Podiatrist	$57.9K	$0
Julie Boutt	MI	Family Medicine Physician	$25.4K	$0
Josephine Kamendat	MI	Family Nurse Practitioner	$21.9K	$0
Ashley Glaza	MI	Family Nurse Practitioner	$15.3K	$0

Autism Systems LLC — Billing Profile & Reimbursement Data

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Autism Systems LLC — 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