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.

Seven Hills Rhode Island Inc (NPI 1275743916)

Field	Value
Entity Type	Organization
Organization	Seven Hills Rhode Island Inc
Address	1 Albion Rd Ste 201
City	Lincoln
State	RI
ZIP	02865
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 23, 2007
NPI Deactivated	April 21, 2023

Payer Source	Total Paid
Medicaid	$31M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available data: there is no Medicare billing on file while lifetime Medicaid revenue is $31M, so Medicaid constitutes the material majority of its public-payer activity and revenue footprint. Analysts should treat this entity as a Medicaid-focused operator rather than a mixed Medicare/Medicaid competitor.

Revenue is highly concentrated in a small set of service codes: the top three Medicaid codes account for 75.1% of the provider's total Medicaid revenue. Those top contributors are T1019 ($13.4M, 43.4%), T1024 ($6.8M, 22.1%), and T1005 ($3M, 9.7%), indicating the business depends on a narrow set of high-volume, high-revenue community support services.

The code mix points to a community-based, long-term support and care-coordination model: T1019 (personal care services), T1024 (evaluation and treatment by an integrated specialty team for multiple or severely handicapped children), and T1005 (respite care) together suggest the provider delivers hands-on personal care, pediatric specialty coordination, and caregiver respite rather than typical outpatient physician services. This pattern aligns with a multi-specialty clinic/center configured to serve high-touch home- and community-based waiver populations.

T1024 is a clear statewide standout: with 47.2K claims and $6.8M revenue it ranks #2 of 91 providers in-state at the 99th percentile and is labeled an extreme outlier, indicating this provider is a major in-state supplier for integrated specialty team services for severely handicapped children. Similarly, H2016 (311.1K claims, $1.2M, 4.0%) ranks #1 of 39 providers at the 100th percentile and is also an extreme outlier, showing dominance in comprehensive community support services by claim volume even though those per-diem payments are low.

By contrast, the largest single-code revenue driver T1019 (119.9K claims, $13.4M, 43.4%) ranks #3 of 30 providers in-state at the 93th percentile and is described as typical/unremarkable volume; this means the provider's biggest dollar generator is large in absolute terms but not uniquely dominant among peers. T1005 (27.5K claims, $3M, 9.7%) ranks #2 of 20 at the 95th percentile and is similarly a high-volume, high-share line that peers also provide at scale.

Several additional service lines show elevated state-level presence for coordination and behavioral support: T1016 case management (86.6K claims, $2.9M, 9.5%) ranks #3 of 180 (99th percentile; notably above typical state volume), and H0046 mental health services (18.5K claims, $2.3M, 7.5%) sits at the 84th percentile. These figures reinforce that care coordination and behavioral health support are significant operational components alongside hands-on personal care and respite services.

Operational billing patterns show many small, recurrent units: H2016 posts 311.1K claims at a $4 avg paid/claim and T1019 posts 119.9K claims, reflecting a high-frequency, low-dollar per-claim model consistent with per-15-minute or per-diem community support billing. This suggests the provider’s service delivery relies on frequent short-interval interventions rather than episodic, high-dollar procedures.

The provider has an established footprint: NPI enumerated 2007-05-23 (~19 years ago), which indicates long-tenured participation in Medicaid programs and likely sustained operational relationships with state waiver and community-based service systems. Longevity helps explain scale in both dominant codes and the provider’s ability to sustain very high claim volumes across multiple service lines.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	119,880	$110	$13.4M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	47,190	$150	$6.8M
T1005	Respite care services, up to 15 minutes	27,540	$110	$3M
T1016	Case management, each 15 minutes	86,580	$30	$2.9M
H0046	Mental health services, not otherwise specified	18,490	$130	$2.3M
H2016	Comprehensive community support services, per diem	311,110	$1	$1.2M
T1027	Family training and counseling for child development, per 15 minutes	14,960	$70	$1M
T2024	Service assessment/plan of care development, waiver	850	$160	$133.1K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	200	$300	$62K

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

Seven Hills Rhode Island Inc — 4 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	3	30	9,040	$150	$5.7M
T1005	Respite care services, up to 15 minutes	2	20	2,540	$190	$1.4M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	2	90	510	$160	$975K
H0046	Mental health services, not otherwise specified	12	70	2,310	$70	$698K
T1027	Family training and counseling for child development, per 15 minutes	7	90	350	$100	$363.8K
T1016	Case management, each 15 minutes	3	180	400	$20	$230.7K
H2016	Comprehensive community support services, per diem	1	40	10,150	$10	$230.4K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	16	40	110	$140	$109.8K
T2024	Service assessment/plan of care development, waiver	1	10	80	$160	$27.8K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Seven Hills Rhode Island Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seven Hills Rhode Island Inc	RI	Developmentally Disabled Services Day Training Agency	$0	$84.1M
Seven Hills Rhode Island Inc	RI	Multi-Specialty Clinic/Center	$0	$9.8M
Seven Hills Rhode Island Inc	RI	Adult Day Care Clinic/Center	$0	$1.3M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fellowship Health Resources, Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$49.1M
Seven Hills Rhode Island Inc	RI	In Home Supportive Care Agency	$0	$22M
Mohammad Suhail	RI	Internal Medicine Physician	$126.3K	$16M
Caregivers Ri, LLC	RI	Home Health Agency	$0	$8.5M
Epoch Sleep Centers, LLC	RI	Sleep Disorder Diagnostic Clinic/Center	$88.3K	$3.8M
Anchor Medical Associates	RI	General Practice Physician	$0	$2.9M
Golden Roads Adult Day Center LLC	RI	Adult Day Care Clinic/Center	$0	$2.3M
Town Of Lincoln Public Schools	RI	Local Education Agency (LEA)	$0	$2.1M
Anchor Counseling Center	RI	Clinical Social Worker	$0	$2.1M
Seven Hills Rhode Island Inc	RI	Case Management Agency	$0	$1.8M

Seven Hills Rhode Island Inc — Billing Profile & Reimbursement Data

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Seven Hills 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

Related Providers

Nearby Providers

Frequently Asked Questions

References