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    OpenPayerNPI Medicare & MedicaidUtah Autism Academy
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    Utah Autism Academy — Billing Profile & Reimbursement Data

    NPI 1972934537 · Midvale, UT · Developmentally Disabled Services Day Training Agency

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    Utah Autism Academy is a developmentally disabled services day training agency provider located in Midvale, Utah. This profile covers 0 Medicare and 9 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationUtah Autism Academy
    Address7434 S State St
    CityMidvale
    StateUT
    ZIP84047
    TaxonomyDevelopmentally Disabled Services Day Training Agency
    NPI EnumeratedDecember 9, 2013

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$8.2M
    Medicare$0

    Key Findings

    UTAH AUTISM ACADEMY is effectively a single‑payer Medicaid provider with no Medicare billing on file; its lifetime Medicaid revenue is $8.2M and there is explicitly no Medicare revenue to compare, indicating operations focused entirely on state Medicaid behavioral health services. The practice has an NPI enumeration date of 2013-12-09 (~13 years ago), establishing more than a decade of active participation in Medicaid reimbursement for developmental disability services. Revenue is highly concentrated in a small set of service codes: the precomputed top three Medicaid codes account for 97.0% of the provider’s total Medicaid revenue, signaling dependence on a narrow set of billable procedures for the bulk of income. The single largest revenue driver is 97153, which generated $5.8M (70.7% of Medicaid revenue) across 24.2K claims at an average $238 paid/claim; this positions the provider as a sizable in-state deliverer of technician‑administered adaptive behavior treatment (rank #8 of 29, 75th percentile), consistent with a service model that relies heavily on technician‑delivered, face‑to‑face ABA interventions. The second and third revenue drivers—0364T ($1.5M, 18.2% of Medicaid revenue; 7.4K claims, rank #3 of 12, 82nd percentile) and 97155 ($666.1K, 8.2% of Medicaid revenue; 11.5K claims, rank #4 of 29, 89th percentile)—both represent higher‑level behavior treatment and clinician‑delivered adaptive behavior services, indicating a mixed staffing model with both technicians and qualified professionals contributing to care delivery. Competitive standing by code is modest to strong in-state: the provider ranks in mid-to-high percentiles for key codes (75th for 97153, 82nd for 0364T, 89th for 97155), which suggests it is a meaningful regional participant but not the single dominant provider statewide for these services. There are notable coding volume observations beyond top revenues: 97154 shows 17.9K claims but low average payment ($11) and $196.4K revenue and is unique in the state sample (ranks #1 of 1), implying the provider may use group‑format technician sessions that are reimbursed at much lower rates per claim; several other codes (0368T, 97151, 97156, 0359T) represent small revenue slices and typical or low percentile ranks, consistent with a focused service mix rather than broad clinical diversification. Overall, the provider’s business profile is that of a specialized developmental disabilities/day training agency with long tenure, heavy reliance on technician‑delivered ABA services for Medicaid reimbursement, and a concentrated revenue base that exposes it to changes in reimbursement or utilization for a very small set of codes.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    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 CodeDescriptionClaimsAvg PaidRevenue
    97153A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…24,240$240$5.8M
    0364TBehavior treatment7,380$200$1.5M
    97155The 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…11,480$60$666.1K
    97154A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…17,850$10$196.4K
    0368TBehavior treatment modified additional3,650$10$32.9K
    97151The 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…70$100$6.6K
    97156The 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…60$70$4.1K
    0359TBehavior identification assessment, by the physician or other qualified health care professional, face-to-face with patient and/or guardian(s)/caregiver(s), includes administration of standardized…10$250$3.5K
    0366TDeleted code, effective Jan. 1, 20195,820$0$0

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Utah median

    9 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    97153A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…8307,130$260$8.7M
    97155The 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…4302,270$140$1.7M
    0364TBehavior treatment3105,310$110$855.5K
    97151The 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…1110340$210$437.7K
    0368TBehavior treatment modified additional2101,470$90$205K
    97154A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…11017,850$10$201.4K
    97156The 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…810140$60$163.1K
    0359TBehavior identification assessment, by the physician or other qualified health care professional, face-to-face with patient and/or guardian(s)/caregiver(s), includes administration of standardized…61030$360$42.4K
    0366TDeleted code, effective Jan. 1, 20191105,820$1$170

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Jordan School DistrictUTLocal Education Agency (LEA)$0$6.6M
    Ihc Health Services IncUTSpecialty Pharmacy$0$6.5M
    National Durable Medical Equipment IncUTProsthetic/Orthotic Supplier$0$3.7M
    Next Level Recovery LLCUTMental Health Clinic/Center (Including Community Mental Health Center)$0$3.2M
    Apria Healthcare LLCUTDurable Medical Equipment & Medical Supplies$0$2.1M
    Community Health Centers, Inc.UTFederally Qualified Health Center (FQHC)$0$1.5M
    Mg Cottonwood Heights Subtenant LLCUTAssisted Living Facility$0$1.4M
    Canyon Creek Property Management LLCUTAssisted Living Facility$0$948.9K
    Eye Care For KidsUTOptometrist$0$863.4K
    Caregiving ServicesUTIn Home Supportive Care Agency$0$808.6K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Utah Providers
    4 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Utah Distribution
    Utah Autism Academy — 0 of 8 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Utah