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.

Re-focus Inc. (NPI 1053608265)

Field	Value
Entity Type	Organization
Organization	Re-focus Inc.
Address	45 Greeley St
City	Providence
State	RI
ZIP	02904
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	July 8, 2011

Payer Source	Total Paid
Medicaid	$102.5M
Medicare	$0

Key Findings

RE-FOCUS INC. is effectively a single-payer Medicaid provider: it has no Medicare billing on file and reports $102.5M in lifetime Medicaid revenue. The NPI was enumerated on 2011-07-08 (~15 years ago), indicating a sustained operating presence in Rhode Island over roughly a decade and a half.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 90.7% of the provider’s Medicaid revenue, driven by T2033 ($61.9M, 60.4%), T2021 ($18.4M, 18.0%), and T2017 ($12.7M, 12.4%). Those three codes together define the bulk of the business and financial exposure for the organization.

The code mix (T2033, T2021, T2017) points to facility- and program-based services focused on developmental-disability supports: T2033 is residential care billed per diem, while T2021 and T2017 reflect day habilitation and residential habilitation billed in time increments. The presence of high average paid/claim amounts — $6772 avg paid/claim for T2033, $735 for T2021, and $1751 for T2017 — reinforces that the operation centers on longer-duration, service-intensive residential and habilitation programs.

Competitive standing by code is broadly middle-to-upper tier but not dominant statewide: T2033 ranks #9 of 22 providers (62th percentile) which suggests a modest, middle-market position for residential per diem services; T2021 ranks #9 of 33 (75th percentile), indicating stronger volume in day habilitation relative to peers; and T2017 ranks #12 of 36 (69th percentile), consistent with an upper-middle presence in residential habilitation. Overall, RE-FOCUS appears to be a meaningful but not leading in-state provider across its core service lines.

RE-FOCUS generates smaller but diversified Medicaid revenue from ancillary services: T2003 (non-emergency transportation) produced $3M (2.9% of Medicaid revenue) and ranks #26 of 55 (54th percentile), T1005 (respite care) produced $2.6M (2.5%) and ranks #9 of 20 (58th percentile), and T2022 (case management) produced $1.8M (1.8%) and ranks #10 of 41 (78th percentile). These secondary lines suggest the provider bundles transportation, respite, and case management alongside core residential/day habilitation offerings, but none comes close to the scale of the top three codes.

The operational and reimbursement profile implies concentration risk and sensitivity to rate or policy changes: T2033 alone is 60.4% of Medicaid revenue with a high per-claim payment ($6772 avg paid/claim), so changes to residential-per-diem policy or utilization would materially affect total revenue. With 90.7% of revenue flowing from three codes, payer or regulatory shifts affecting residential or habilitation services would disproportionately impact the organization’s finances.

Several low-volume lines highlight service gaps or limited market penetration: H2016 generated $503.1K (0.5%) and ranks #38 of 39 (3th percentile), H0004 produced $640 (0.0%) and ranks #74 of 78 (5th percentile), and multiple other codes account for negligible shares of revenue. Those low ranks and dollar amounts indicate RE-FOCUS maintains little presence in comprehensive community support services and behavioral-health counseling relative to most in-state peers, underscoring a focused service portfolio rather than a broad Medicaid clinical footprint.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	9,140	$6,770	$61.9M
T2021	Day habilitation, waiver; per 15 minutes	25,080	$740	$18.4M
T2017	Habilitation, residential, waiver; 15 minutes	7,250	$1,750	$12.7M
T2003	Non-emergency transportation; encounter/trip	7,860	$380	$3M
T1005	Respite care services, up to 15 minutes	3,820	$680	$2.6M
T2022	Case management, per month	11,980	$150	$1.8M
T2015	Habilitation, prevocational, waiver; per hour	560	$2,060	$1.1M
H2016	Comprehensive community support services, per diem	160	$3,230	$503.1K
T1002	Rn services, up to 15 minutes	1,280	$270	$339.7K
T2020	Day habilitation, waiver; per diem	100	$600	$62.5K

Showing 1–10 of 13

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

Re-focus Inc. — 0 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	9	20	6,780	$1,890	$39.8M
T2017	Habilitation, residential, waiver; 15 minutes	12	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	9	30	12,340	$410	$10M
T1005	Respite care services, up to 15 minutes	9	20	2,540	$190	$1.4M
T2022	Case management, per month	10	40	5,460	$150	$1.2M
T2003	Non-emergency transportation; encounter/trip	26	60	7,480	$80	$1.1M
T2020	Day habilitation, waiver; per diem	14	20	450	$950	$864.4K
T2019	Habilitation, supported employment, waiver; per 15 minutes	13	10	1,870	$230	$688.6K
T2015	Habilitation, prevocational, waiver; per hour	6	20	330	$460	$396.2K
T1002	Rn services, up to 15 minutes	7	30	280	$110	$253.3K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Re-focus Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Providence Center Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$170.9M
Hopehealth Hospice & Palliative Care	RI	Community Based Hospice Care Agency	$0	$33.3M
Mas Medical Staffing	RI	Home Health Agency	$0	$24.5M
Generations Adult Day Health Center	RI	Adult Day Care Clinic/Center	$0	$16.3M
Prospect Chartercare Sjhsri, LLC	RI	General Acute Care Hospital	$0	$10.9M
Global Homecare And Staffing Inc	RI	Home Health Agency	$0	$8.3M
Emergency Care Services Of New England PC	RI	Emergency Medicine Physician	$0	$6.9M
State Of Rhode Island	RI	Clinical Medical Laboratory	$570	$6.4M
The Providence Center	RI	Community/Behavioral Health Agency	$0	$5.9M
St. Joseph Health Services Of Ri	RI	General Acute Care Hospital	$0	$5.9M

Re-focus Inc. — Billing Profile & Reimbursement Data

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Re-focus Inc. — 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