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.

University Pediatricians Autism Center (NPI 1972862902)

Field	Value
Entity Type	Organization
Organization	University Pediatricians Autism Center
Address	21600 Novi Rd Ste 800
City	Novi
State	MI
ZIP	48375
Taxonomy	Behavior Analyst
NPI Enumerated	May 11, 2012

Payer Source	Total Paid
Medicaid	$9.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 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…	35,080	$180	$6.2M
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…	8,780	$130	$1.2M
0365T	Adaptive behavior tx addl	4,090	$280	$1.1M
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…	1,860	$90	$165.5K
0369T	Duodenal mucosal resurfacing, endoscopic	1,650	$100	$163.3K
0364T	Behavior treatment	4,170	$30	$116.7K
0368T	Behavior treatment modified additional	1,890	$60	$113.3K
0370T	Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present)	290	$120	$34.4K
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…	40	$230	$8.2K

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

University Pediatricians Autism Center — 0 of 9 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

9 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…	37	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…	37	130	3,170	$180	$2.2M
0365T	Adaptive behavior tx addl	28	70	3,180	$170	$1.5M
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…	53	60	200	$380	$398.1K
0369T	Duodenal mucosal resurfacing, endoscopic	17	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…	31	100	910	$90	$283.6K
0364T	Behavior treatment	22	70	2,990	$30	$231.4K
0368T	Behavior treatment modified additional	16	70	900	$60	$131K
0370T	Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present)	18	40	200	$120	$78.3K

Nearby Providers

Other providers in the same ZIP code as University Pediatricians Autism Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cns Healthcare	MI	Psychiatry Physician	$0	$214.3M
Biotech Clinical Laboratories Inc	MI	Clinical Medical Laboratory	$8.1M	$49.9M
Theoria Medical	MI	Internal Medicine Physician	$0	$9.6M
Novi Surgery Center LLC	MI	Ambulatory Surgical Clinic/Center	$1.5M	$0
Eric Kovan	MI	Physical Medicine & Rehabilitation Physician	$510.6K	$0
Dorin Deitch	MI	Physical Medicine & Rehabilitation Physician	$283.1K	$0
Jenny Michaels	MI	Physical Medicine & Rehabilitation Physician	$251K	$0
Jessica Martinelli	MI	Nurse Practitioner	$178.5K	$0
Michael Haenick	MI	Physical Medicine & Rehabilitation Physician	$167.1K	$0
Thomas Sheppard	MI	Physical Therapist	$153.2K	$0

University Pediatricians Autism Center — Billing Profile & Reimbursement Data

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University Pediatricians Autism Center — 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