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.

Caregiver Homes Of Rhode Island Inc. (NPI 1255655502)

Field	Value
Entity Type	Organization
Organization	Caregiver Homes Of Rhode Island Inc.
Address	235 Promenade St Rm 417
City	Providence
State	RI
ZIP	02908
Taxonomy	Case Management Agency
NPI Enumerated	March 16, 2010

Payer Source	Total Paid
Medicaid	$43.4M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer Medicaid operation, reporting $43.4M in lifetime Medicaid revenue. The absence of Medicare activity means all billing- and utilization-based analyses should focus on Medicaid waiver and long-term services codes.

Medicaid revenue is highly concentrated: the precomputed top three codes account for 91.9% of this provider's total Medicaid revenue, indicating most of the business is driven by a very small set of service lines rather than a broad mix of Medicaid CPT/HCPCS codes. That concentration creates dependency on a handful of programmatic payment streams.

S5136 is the single largest revenue driver, with $24.8M (57.1% of this provider's Medicaid revenue) reported for companion care per diem services. The record shows the provider ranks #1 of 1 in-state for S5136 (0th percentile; no state peer volume comparison available), which suggests it is effectively the sole in-state reporter for this code and that companion/home support services are the core business.

T2025 (waiver services, NOS) is the second-largest contributor at $10.5M (24.1% of Medicaid revenue) and is flagged as an extreme outlier, ranking #1 of 25 providers in-state (100th percentile). This positioning indicates unusually high involvement in waiver program billing compared with other state providers and implies substantial operational focus on Medicaid waiver administration or delivery.

T2033 (residential care, waiver; per diem) contributes $4.6M (10.6% of Medicaid revenue) and ranks #2 of 22 providers in-state (95th percentile; extreme outlier). The volume and rank for T2033 point to a significant residential waiver component in the provider's service mix, meaning they operate both in-home companion services and higher-intensity residential waiver care.

Other Medicaid codes further illustrate the service mix: T1005 (respite care, up to 15 minutes) generated $3.5M (8.1% of Medicaid revenue) and ranks #1 of 20 in-state (100th percentile; extreme outlier), showing material respite service delivery; by contrast, T1028 generated only $15.9K (negligible share) and ranks #4 of 4 (0th percentile), which is unremarkable. These secondary codes confirm a portfolio centered on home- and community-based supports with some ancillary, low-volume assessments.

Taken together, the code descriptions and revenue distribution indicate CAREGIVER HOMES OF RHODE ISLAND INC. functions primarily as a home- and community-based services (HCBS) and long-term services and supports (LTSS) provider focused on companion care, waiver services, residential waiver care, and respite. The mix is not consistent with acute medical or procedure-driven operations, but rather ongoing personal care and waiver-program delivery.

From a competitive and risk perspective, the provider ranks at or near the top statewide on multiple codes (several marked as extreme outliers), which signals dominance in Rhode Island for waiver- and companion-oriented billing. However, the heavy concentration in a few Medicaid codes also exposes the organization to policy or rate changes affecting those specific waiver and companion care payments. The NPI was enumerated on 2010-03-16 (~16 years ago), indicating long-standing participation in the Medicaid program.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5136	Companion care, adult (e.g., iadl/adl); per diem	538,600	$50	$24.8M
T2025	Waiver services; not otherwise specified (nos)	388,130	$30	$10.5M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	149,040	$30	$4.6M
T1005	Respite care services, up to 15 minutes	61,660	$60	$3.5M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	70	$230	$15.9K

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

Caregiver Homes Of Rhode Island Inc. — 3 of 5 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	2	20	6,780	$1,890	$39.8M
S5136	Companion care, adult (e.g., iadl/adl); per diem	1	10	538,600	$50	$25M
T1005	Respite care services, up to 15 minutes	1	20	2,540	$190	$1.4M
T2025	Waiver services; not otherwise specified (nos)	1	30	620	$70	$1.2M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	4	10	110	$70	$58.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A Caring Experience Nursing Services, Inc.	RI	Home Health Agency	$0	$78.5M
Prospect Chartercare Rwmc, LLC	RI	General Acute Care Hospital	$0	$57.1M
Roger Williams Medical Center	RI	Surgical Oncology Physician	$0	$5.4M
John Ricci	RI	Dentist	$0	$4.3M
Meals On Wheels Of Ri, Inc.	RI	Case Manager/Care Coordinator	$0	$4.1M
Professional Ambulance LLC	RI	Ambulance	$1.7M	$1.4M
University Pathologists, LLC	RI	Anatomic Pathology Physician	$0	$2.9M
Prospect Chartercare Rwmc, LLC	RI	Internal Medicine Physician	$0	$2.4M
Antonio Barajas	RI	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.1M
Nakitta Noel	RI	Emergency Medicine Physician	$32.3K	$1.5M

Caregiver Homes Of Rhode Island Inc. — Billing Profile & Reimbursement Data

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Caregiver Homes Of Rhode Island 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