Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Rhode Island for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Rhode Island only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Rhode Island (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

The Cove Center, Inc. (NPI 1023305356)

Field	Value
Entity Type	Organization
Organization	The Cove Center, Inc.
Address	610 Manton Ave
City	Providence
State	RI
ZIP	02909
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	July 7, 2011

Payer Source	Total Paid
Medicaid	$58.7M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the available claims data: there is no Medicare billing on file and all recorded fee‑for‑service revenue is Medicaid, totaling $58.7M. The absence of Medicare activity makes Medicaid the sole visible public revenue stream and the primary lens for evaluating business operations and payer exposure.

Revenue concentration is very high: the precomputed top 3 Medicaid codes by revenue account for 92.3% of this provider's total Medicaid revenue. Those three codes are T2033 ($40.1M, 68.2%), T2021 ($11.6M, 19.8%), and T2003 ($2.5M, 4.3%), which together dominate the reported Medicaid receipts.

The code mix indicates an operational focus on residential waiver and day habilitation services for people with developmental disabilities. T2033 (Residential care, waiver; per diem) is the single largest revenue driver, and T2021 (Day habilitation, waiver; per 15 minutes) is the second largest, signaling that on‑site residential and day‑program services are the core service lines rather than episodic medical care.

Per‑claim payment levels emphasize the revenue role of per‑diem residential payments: T2033 shows a high average paid/claim of $7227 while T2021 reports $763 avg paid/claim and T2003 (non‑emergency transportation; encounter/trip) reports $478 avg paid/claim. These payment profiles make the per‑diem residential code the most productive revenue stream on a per‑claim basis and a primary driver of the provider’s $58.7M Medicaid total.

Despite large absolute Medicaid revenue, the provider is not a dominant statewide player for its top codes based on rank and percentile. T2033 ranks #13 of 22 providers in‑state (43th percentile) and is described as "typical, unremarkable volume for this code," T2021 ranks #15 of 33 (56th percentile, "typical, unremarkable volume for this code"), and T2003 ranks #32 of 55 (43th percentile, "typical, unremarkable volume for this code"). These positions indicate modest market standing rather than top‑tier dominance.

Several ancillary waiver and support codes contribute only small shares of revenue, reinforcing the narrow service mix: T2017 ($2.4M, 4.1%) ranks #26 of 36 providers in‑state (29th percentile), T2022 ($946.6K, 1.6%) ranks #18 of 41 (57th percentile), and T1005 ($616.8K, 1.1%) ranks #15 of 20 (26th percentile). State comparisons for these codes are generally characterized as "typical, unremarkable volume" or lower percentiles, underscoring that most non‑residential revenue streams are modest.

The provider has an established enrollment history, with an NPI enumerated on 2011-07-07 (~15 years ago), which is consistent with sustained Medicaid billing and the accumulation of $58.7M in lifetime Medicaid revenue. That tenure suggests an operational track record in the residential/day habilitation market segment.

From a risk‑and‑strategy perspective, the heavy dependence on a small set of waiver codes (92.3% concentrated in the top three codes) means that changes in waiver rules, per‑diem rates, or utilization patterns for T2033 and T2021 would materially affect the provider’s revenue base. The existing rank/percentile patterns imply that this is a revenue‑concentrated but not market‑leading provider within Rhode Island’s waiver ecosystem.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	5,540	$7,230	$40.1M
T2021	Day habilitation, waiver; per 15 minutes	15,230	$760	$11.6M
T2003	Non-emergency transportation; encounter/trip	5,290	$480	$2.5M
T2017	Habilitation, residential, waiver; 15 minutes	1,970	$1,220	$2.4M
T2022	Case management, per month	6,270	$150	$946.6K
T1005	Respite care services, up to 15 minutes	500	$1,240	$616.8K
T2019	Habilitation, supported employment, waiver; per 15 minutes	1,380	$310	$421.8K
T2025	Waiver services; not otherwise specified (nos)	230	$400	$91.7K
T1002	Rn services, up to 15 minutes	160	$80	$12.5K
97151	The 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…	60	$70	$4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

The Cove Center, Inc. — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	13	20	6,780	$1,890	$39.8M
T2017	Habilitation, residential, waiver; 15 minutes	26	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	15	30	12,340	$410	$10M
T1005	Respite care services, up to 15 minutes	15	20	2,540	$190	$1.4M
T2025	Waiver services; not otherwise specified (nos)	18	30	620	$70	$1.2M
T2022	Case management, per month	18	40	5,460	$150	$1.2M
T2003	Non-emergency transportation; encounter/trip	32	60	7,480	$80	$1.1M
T2019	Habilitation, supported employment, waiver; per 15 minutes	8	10	1,870	$230	$688.6K
T1002	Rn services, up to 15 minutes	18	30	280	$110	$253.3K
97151	The 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…	3	10	60	$190	$30K

Nearby Providers

Other providers in the same ZIP code as The Cove Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Groden Center, Inc.	RI	Community/Behavioral Health Agency	$0	$6.6M
Easter Seals Rhode Island	RI	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$6.5M
Groden Center, Inc.	RI	Community/Behavioral Health Agency	$0	$4.4M
Groden Center, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$3.3M
Codac Inc	RI	Methadone Clinic	$206.4K	$2.7M
Upward Health Solutions Rhode Island LLC	RI	Case Management Agency	$0	$2M
Easter Seals Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$1.7M
Jessica Waugh	RI	Behavior Analyst	$0	$1.6M
Lonice Thomas	RI	Pediatrics Physician	$0	$1.1M
Karen Ng	RI	Family Medicine Physician	$430	$889.2K

The Cove Center, Inc. — Billing Profile & Reimbursement Data

Sign up for The Cove Center, Inc. — Billing Profile & Reimbursement Data policy alerts

The Cove Center, Inc. — Billing Profile & Reimbursement Data

Sign up for The Cove Center, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References