This provider averages 105 services per working day
Based on 262.9K total services over 10 years (250 working days/year). Learn about impossible service volumes →
This provider's $6.1M in total Medicare payments ranks in the 99th percentile of Physical Therapist in Private Practice providers nationally.
Averaging 105 services per working day raises questions about billing patterns.
Medicare payments to this provider grew 149% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 70% in 2015
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 | $69.00 | $28.90 | 2.39x | $40.10 | $174.2K | 7.5K | 297 |
| 2015 | $69.01 | $31.10 | 2.22x | $37.91 | $295.5K | 13.0K | 412 |
| 2016 | $69.00 | $31.96 | 2.16x | $37.04 | $484.0K | 21.4K | 630 |
| 2017 | $69.00 | $33.79 | 2.04x | $35.21 | $645.5K | 28.3K | 1.1K |
| 2018 | $80.20 | $37.42 | 2.14x | $42.78 | $907.9K | 37.5K | 1.6K |
| 2019 | $80.20 | $38.76 | 2.07x | $41.44 | $1.0M | 42.1K | 1.5K |
| 2020 | $76.00 | $36.48 | 2.08x | $39.52 | $727.3K | 29.8K | 1.3K |
| 2021 | $79.80 | $38.78 | 2.06x | $41.02 | $713.5K | 29.3K | 1.1K |
| 2022 | $80.53 | $37.16 | 2.17x | $43.37 | $650.1K | 32.1K | 1.2K |
| 2023 | $87.75 | $40.00 | 2.19x | $47.75 | $434.4K | 21.8K | 883 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 97530 | Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes | 84.2K | $2.3M | $27.18 | 2.02x |
| 97112 | Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 87.2K | $1.9M | $21.67 | 2.22x |
| 97110 | Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 87.1K | $1.7M | $19.51 | 2.46x |
| 97162 | Evaluation of physical therapy, typically 30 minutes | 1.5K | $109.1K | $75.05 | 1.78x |
| 97116 | Walking training to 1 or more areas, each 15 minutes | 2.3K | $47.6K | $20.36 | 2.70x |
| 97164 | Re-evaluation of physical therapy, typically 20 minutes | 307 | $16.4K | $53.28 | 2.43x |
| 97001 | Physical therapy evaluation | 248 | $13.8K | $55.80 | 2.24x |
| 97535 | Training for self-care or home management, each 15 minutes | 16 | $374.52 | $23.41 | 2.28x |
This provider submits charges 2.21 times higher than what Medicare actually pays.
A markup ratio of 2.21x means for every $100 Medicare pays, this provider initially charges $221. This is higher 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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