Balance Autism

Balance Autism was paid $34.84M by Medicaid between Jan 2018 and Nov 2024, across 18 billing codes. Its largest line is 97153, applied behavior analysis (autism therapy), per 15 minutes — 52% of everything it billed.

33Billing provider infoBALANCE AUTISM
ALTOONA, IA 50009

33aNPI1437290129assigned 02/08/2007

33bProvider typeBehavioral Analyst

28Total paid$34.84M

24GClaims305,679

24DCodes billed18

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Behavioral Analyst providers in Iowa

Rank by total paid#2 of 6

Median peer was paid$3.14M

This provider vs. median11×

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.

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
2018	49,039	$6.49M
2019	52,297	$4.85M
2020	35,925	$4.35M
2021	43,223	$5.44M
2022	44,572	$4.89M
2023	50,903	$5.03M
2024incomplete	29,720	$3.78M

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	52%	148,567	9,880	$17.96M
G9012	Other specified case management service not elsewhere classified	14%	48,901	12,409	$4.80M
97154		7.4%	26,444	2,932	$2.58M
H2016	Community support for mental illness or disability, billed per dayComprehensive community support services, per diem	6.4%	6,192	305	$2.24M
H2019	Therapeutic behavioral services, billed per 15 minutesTherapeutic behavioral services, per 15 minutes	6.2%	24,735	1,495	$2.14M
97156		4.1%	25,455	9,200	$1.43M
97155	Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes	3.2%	7,871	2,444	$1.11M
97151		2.8%	6,577	2,586	$990K
S5136	Companion care, adult (e.g., iadl/adl); per diem	2.4%	2,349	117	$852K
H2015	Community support for mental illness or disability, per 15 minutesComprehensive community support services, per 15 minutes	<1%	676	496	$237K
S5110	Home care training, family; per 15 minutes	<1%	4,059	1,322	$209K
H2014	Skills training and development, per 15 minutes	<1%	2,159	272	$167K

6 more codes

S5108	Home care training to home care client, per 15 minutes	<1%	902	$66K
97158		<1%	340	$22K
H0032	Mental health service plan development by non-physician	<1%	208	$12K
97152		<1%	60	$5K
T1005	Respite care services, up to 15 minutes	<1%	145	$5K
97157		<1%	39	$2K

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 officialMARKLEY, LUANN (DIRECTOR OF OPERATIONS)