The Missing Piece ABA Therapy

The Missing Piece ABA Therapy was paid $1.48M by Medicaid between Jan 2024 and Dec 2024, across 2 billing codes. Its largest line is 97153, applied behavior analysis (autism therapy), per 15 minutes — 98% of everything it billed.

33Billing provider infoTHE MISSING PIECE ABA THERAPY
KENDALLVILLE, IN 46755

33aNPI1063081156assigned 06/22/2021

33bProvider typeBehavior Technician

28Total paid$1.48M

24GClaims3,979

24DCodes billed2

24AFirst – last monthJan 2024 – Dec 2024

Compared with peers

Next to other Behavior Technician providers in Indiana

Rank by total paid#2 of 5

Median peer was paid$302K

This provider vs. median4.9×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration98% of spending on code 97153 with only 2 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2024incomplete	3,979	$1.48M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
97153	Applied behavior analysis (autism therapy), per 15 minutesAdaptive behavior treatment by protocol, administered by technician, each 15 minutes	98%	3,757	194	$1.45M
97155	Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes	2.1%	222	72	$31K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialHALL, SONIA (BCBA)