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.

Community Living Of Rhode Island (NPI 1053538041)

Field	Value
Entity Type	Organization
Organization	Community Living Of Rhode Island
Address	349 Centerville Road Bldg 6
City	Warwick
State	RI
ZIP	02886
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	April 19, 2007

Payer Source	Total Paid
Medicaid	$65.7M
Medicare	$0

Key Findings

This entity has no Medicare billing on file and reports $65.7M in lifetime Medicaid revenue, making its business effectively single-payer (Medicaid)-dependent rather than balanced across Medicare and Medicaid. Analysts should treat Medicaid policy and waiver changes as the primary revenue risk/driver for this provider.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 94.0% of this provider's total Medicaid revenue. The single largest line is T2033 (Residential care, waiver; per diem) at $41M (62.3% of Medicaid revenue), followed by T2021 (Day habilitation, per 15 minutes) at $13.7M (20.8%) and T2017 (Habilitation, residential, per 15 minutes) at $7.1M (10.9%).

The code mix indicates an operational focus on residential and day habilitation services consistent with its taxonomy as a Developmentally Disabled Services Day Training Agency: T2033’s dominance signals large per‑diem residential placements, while high claim counts for T2021 (11.9K claims, $1149 avg paid/claim) point to active day habilitation programming. Together these services form the organization’s core programmatic footprint and revenue engine.

Competitive standing in-state is modest rather than dominant for the top lines: T2033 ranks #14 of 22 providers (38th percentile) and is described as a typical, unremarkable volume position; T2021 ranks #18 of 33 (47th percentile) and likewise sits near the middle of peers; T2017 ranks #23 of 36 (37th percentile). These placements suggest the provider is a routine, mid-size participant in Rhode Island’s waiver market rather than a market leader for these specific codes.

Although T2033 generates the largest share of revenue, its economics are driven by a high average paid per claim ($8333) across 4.9K claims, indicating that per‑diem residential payments — not sheer claim volume — drive the bulk of dollars. By contrast, T2021 shows much higher claim volume (11.9K claims) but a lower avg paid/claim ($1149), underscoring a revenue profile that mixes high-rate residential stays with high-frequency, lower-unit day habilitation services.

Several ancillary waiver and support codes contribute small but meaningful supplemental revenue: T2003 (Non-emergency transportation) produced $2.9M (4.4% of Medicaid revenue) across 5.1K claims, T2022 (Case management) accounted for $755.7K (1.1%), and T1002 (RN services) added $105.2K (0.2%). These lines reflect typical supportive services bundled around residential and day habilitation operations rather than distinct business units.

There are niche capabilities with limited revenue impact: 97151 (assessment/behavioral evaluation) ranks #1 of 5 in-state (100th percentile) but represents only $108.9K (0.2% of Medicaid revenue), indicating the provider may be one of few in-state billing that code yet it remains a small supplement to core waiver services. This suggests capability breadth without material diversification of revenue.

The provider’s NPI has been enumerated since 2007-04-19 (~19 years ago), indicating long tenure in the state waiver market; combined with the concentrated Medicaid revenue base, this longevity likely reflects established payer arrangements and operational experience in residential and day habilitation service delivery rather than rapid growth into other payer channels.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	4,920	$8,330	$41M
T2021	Day habilitation, waiver; per 15 minutes	11,910	$1,150	$13.7M
T2017	Habilitation, residential, waiver; 15 minutes	2,460	$2,900	$7.1M
T2003	Non-emergency transportation; encounter/trip	5,060	$570	$2.9M
T2022	Case management, per month	4,340	$170	$755.7K
T2025	Waiver services; not otherwise specified (nos)	370	$360	$131K
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…	410	$270	$108.9K
T1002	Rn services, up to 15 minutes	370	$280	$105.2K

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

Community Living Of Rhode Island — 1 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	14	20	6,780	$1,890	$39.8M
T2017	Habilitation, residential, waiver; 15 minutes	23	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	18	30	12,340	$410	$10M
T2025	Waiver services; not otherwise specified (nos)	16	30	620	$70	$1.2M
T2022	Case management, per month	23	40	5,460	$150	$1.2M
T2003	Non-emergency transportation; encounter/trip	33	60	7,480	$80	$1.1M
T1002	Rn services, up to 15 minutes	11	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…	1	10	60	$190	$30K

Nearby Providers

Other providers in the same ZIP code as Community Living Of Rhode Island, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M
J.arthur Trudeau Memorial Home Based Therapy Services	RI	Community/Behavioral Health Agency	$0	$20.3M

Community Living Of Rhode Island — Billing Profile & Reimbursement Data

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Community Living Of Rhode Island — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References