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 Maine for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Maine 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. Maine (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.

Gateway Community Services, LLC (NPI 1083082630)

Field	Value
Entity Type	Organization
Organization	Gateway Community Services, LLC
Address	999 Forest Ave
City	Portland
State	ME
ZIP	04103
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 11, 2015

Payer Source	Total Paid
Medicaid	$30.2M
Medicare	$0

Key Findings

GATEWAY COMMUNITY SERVICES, LLC is classified as a Community/Behavioral Health Agency and its Medicaid code mix (H2015, H2021, H0004, T1017, T1019 and notably T1013) indicates operations centered on community-based behavioral health, time-based care coordination, and supportive services delivered outside inpatient settings. The presence of multiple per-15-minute codes suggests service delivery that is predominantly outpatient and community-facing rather than episodic facility-based care.

Revenue is highly concentrated: the provider reports Total Medicaid revenue of $30.2M and its top three Medicaid codes (H2015, T1013, T1017) together account for 66.0% of that Medicaid revenue. Those three codes individually represent $9.9M (32.7%), $5.3M (17.6%), and $4.7M (15.7%) respectively, showing a small set of services drive the majority of receipts.

This entity is effectively single-payer in scope at present: there is no Medicare billing on file, so Medicaid represents the provider's operative payer relationship and the full scale of reported public reimbursement. Analysts should treat Medicaid policy, rate changes, and utilization shifts as the primary financial levers for this provider.

Competitive standing within Maine is strong for several high-volume codes. H2015 (77.1K claims, $9.9M revenue) ranks #3 of 71 providers in-state at the 97th percentile (notably above typical state volume), T1013 (52.6K claims, $5.3M revenue) ranks #1 of 54 at the 100th percentile and is labeled an extreme outlier, and T1017 (41.3K claims, $4.7M revenue) ranks #8 of 104 at the 93th percentile (notably above typical state volume). Together these ranks indicate the provider is a major in-state participant for several community behavioral-health and care-management services.

The dominance of T1013 in the payer mix (52.6K claims, $101 avg paid/claim, $5.3M revenue; 17.6% of Medicaid revenue) and its characterization as an extreme outlier implies the organization provides sign language/oral interpretive services at an unusually large scale. This pattern suggests specialized operational capabilities and likely significant investment in interpreter resources and associated billing workflows compared with typical peers.

Operational and revenue risk is concentrated in time-based per-15-minute services: H2015, T1013, T1017, T1019 and H2021 are all billed on a per-15-minute basis and collectively drive a majority of revenue. Because reimbursement and utilization for these codes are sensitive to changes in per-minute rates, session lengths, and care-plan authorizations, the provider's financial performance could be materially affected by policy or utilization shifts focused on time-based services.

The provider's NPI was enumerated on 2015-09-11 (~11 years ago), indicating more than a decade of active enrollment. Combined with high in-state ranks and concentrated Medicaid revenue, the tenure supports the view that GATEWAY COMMUNITY SERVICES is an established Medicaid service provider in Maine rather than a recent market entrant.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2015	Comprehensive community support services, per 15 minutes	77,140	$130	$9.9M
T1013	Sign language or oral interpretive services, per 15 minutes	52,570	$100	$5.3M
T1017	Targeted case management, each 15 minutes	41,300	$120	$4.7M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	37,550	$110	$4.2M
H2021	Community-based wrap-around services, per 15 minutes	15,990	$220	$3.4M
H0004	Behavioral health counseling and therapy, per 15 minutes	19,120	$130	$2.4M
H2000	Comprehensive multidisciplinary evaluation	1,040	$120	$126.8K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Gateway Community Services, LLC — 2 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2021	Community-based wrap-around services, per 15 minutes	33	100	8,660	$290	$5.1M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	15	110	8,200	$220	$4.7M
H2015	Comprehensive community support services, per 15 minutes	3	70	7,120	$100	$1.7M
T1017	Targeted case management, each 15 minutes	8	100	4,690	$90	$1M
H0004	Behavioral health counseling and therapy, per 15 minutes	29	290	860	$80	$805.1K
T1013	Sign language or oral interpretive services, per 15 minutes	1	50	740	$90	$453.3K
H2000	Comprehensive multidisciplinary evaluation	9	90	70	$100	$35.4K

Nearby Providers

Other providers in the same ZIP code as Gateway Community Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Granite Bay Care, Inc	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$281.6M
Spurwink Services	ME	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$112.7M
Cor Health Services LLC	ME	Home Health Agency	$0	$55.9M
Spurwink Services Incorporated	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$52.9M
Casa, Inc.	ME	Adult Care Home Facility	$0	$50.1M
Peregrine Corporation	ME	Case Management Agency	$0	$30M
Ubuntu Care	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$27.3M
New England Integrated Living Support	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$22.3M
Affinity	ME	Developmentally Disabled Services Day Training Agency	$0	$9.7M
Ocean Home Care LLC	ME	Personal Care Attendant	$0	$9M

Gateway Community Services, LLC — Billing Profile & Reimbursement Data

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Gateway Community Services, LLC — 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