This provider averages 73 services per working day
Based on 182.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $4.4M in total Medicare payments ranks in the 99th percentile of Occupational Therapist in Private Practice providers nationally.
Averaging 73 services per working day raises questions about billing patterns.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 93% in 2017
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2014 | $55.60 | $28.17 | 1.97x | $27.43 | $484.8K | 23.0K | 2.8K |
| 2015 | $56.10 | $29.20 | 1.92x | $26.90 | $404.6K | 17.0K | 2.4K |
| 2016 | $55.11 | $29.34 | 1.88x | $25.77 | $251.8K | 10.4K | 1.3K |
| 2017 | $64.35 | $33.42 | 1.93x | $30.93 | $485.9K | 19.5K | 2.5K |
| 2018 | $60.45 | $32.01 | 1.89x | $28.44 | $321.5K | 12.6K | 1.4K |
| 2019 | $59.29 | $31.49 | 1.88x | $27.80 | $387.5K | 15.3K | 1.9K |
| 2020 | $64.17 | $36.43 | 1.76x | $27.74 | $410.4K | 15.5K | 1.6K |
| 2021 | $64.17 | $37.83 | 1.70x | $26.34 | $577.4K | 21.9K | 1.8K |
| 2022 | $64.21 | $35.46 | 1.81x | $28.75 | $622.6K | 26.5K | 2.2K |
| 2023 | $64.23 | $34.18 | 1.88x | $30.05 | $476.6K | 21.2K | 1.8K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 42.4K | $1.0M | $24.48 | 1.84x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 47.6K | $1.0M | $21.16 | 2.11x |
| 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 42.3K | $808.9K | $19.14 | 2.34x |
| 97530 | Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes | 18.3K | $609.1K | $33.31 | 1.48x |
| 97535 | Self-care or home management training, each 15 minutes | 16.2K | $481.4K | $29.70 | 1.67x |
| 97166 | Evaluation of occupational therapy, typically 45 minutes | 2.8K | $242.0K | $87.14 | 1.72x |
| 97003 | Occupational therapy evaluation | 1.0K | $76.5K | $74.66 | 1.93x |
| 97004 | Occupational therapy re-evaluation | 1.0K | $48.1K | $47.47 | 1.60x |
| 97035 | Application of ultrasound to 1 or more areas, each 15 minutes | 4.6K | $41.7K | $9.09 | 3.30x |
| 97124 | Therapeutic massage to 1 or more areas, each 15 minutes | 2.2K | $38.7K | $17.48 | 2.57x |
| 97018 | Application of hot wax bath to 1 or more areas | 4.4K | $27.6K | $6.25 | 4.83x |
| 97168 | Re-evaluation of occupational therapy established plan of care, typically 30 minutes | 48 | $2.3K | $47.59 | 2.10x |
| 97113 | Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes | 31 | $902.08 | $29.10 | 1.72x |
This provider submits charges 1.96 times higher than what Medicare actually pays.
A markup ratio of 1.96x means for every $100 Medicare pays, this provider initially charges $196. This is lower than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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