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.

West Bay Residential Services Inc. (NPI 1336435031)

Field	Value
Entity Type	Organization
Organization	West Bay Residential Services Inc.
Address	158 Knight St
City	Warwick
State	RI
ZIP	02886
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	June 22, 2011

Payer Source	Total Paid
Medicaid	$145.8M
Medicare	$0

Key Findings

WEST BAY RESIDENTIAL SERVICES INC. is effectively a single-payer Medicaid provider: it has no Medicare billing on file and reports $145.8M in lifetime Medicaid revenue, indicating its operations are focused almost entirely on Medicaid-funded developmental disability services rather than Medicare-covered care. The absence of Medicare activity suggests its service mix and patient population are concentrated in long-term supports and waiver programs rather than acute or elderly/disabled Medicare services.

Revenue is highly concentrated in a small set of Medicaid waiver codes: the top 3 Medicaid codes by revenue account for 93.0% of the provider's total Medicaid revenue, signaling dependence on a few core service lines. That concentration implies financial sensitivity to rate changes, authorization policy shifts, or utilization changes for those specific waiver services.

The dominant revenue driver is T2033 (Residential care, nos, waiver; per diem), which produced $103.7M and represents 71.1% of the provider's Medicaid revenue. This large share indicates WEST BAY operates primarily as a residential habilitation/provider of group/residential placements under the waiver program, with a business model centered on per-diem residential care rather than dispersed outpatient or short-visit services.

T2021 (Day habilitation, waiver; per 15 minutes) is the provider's second major line with $24.4M (16.7% of Medicaid revenue), and T2017 (Habilitation, residential, waiver; 15 minutes) contributes $7.6M (5.2%). Together these codes show a service mix combining residential supports with structured day habilitation and in-residence habilitation therapy, reflecting an integrated day-and-residential model common for developmentally disabled services.

Competitive standing by code is mixed but generally modest to strong within Rhode Island: for T2033 the provider ranks #5 of 22 (81th percentile), indicating it is a meaningful but not dominant residential provider statewide. For T2021 it ranks #10 of 33 (72th percentile), a typical volume position among day habilitation vendors, and for T2017 it ranks #15 of 36 (60th percentile), indicating more modest participation in 15-minute habilitation billing relative to peers.

There are notable outlier signals on a few secondary codes: WEST BAY ranks #1 of 15 (100th percentile) for T2020 (Day habilitation, waiver; per diem), characterized in the data as notably above typical state volume for this code, which suggests a unique strength or strategic emphasis on per-diem day habilitation at scale relative to other providers. Conversely, codes such as S5125 (attendant care) and T2019 (supported employment) register very low ranks (5th and 0th percentile respectively), indicating these services are either not core to their mix or are offered at very limited scale.

Operational tenure is long-established: the NPI was enumerated on 2011-06-22 (approximately 15 years ago), which supports the interpretation that the provider has an established presence and experience delivering waiver-funded developmental disability services in Rhode Island. That tenure aligns with the deep revenue accumulation in core waiver codes.

The broader code portfolio shows some ancillary service billing (e.g., T2003 non-emergency transportation at $3.2M and T2022 case management at $2.0M) consistent with the logistical and care-coordination needs of a residential/day habilitation operator. These secondary revenue streams are meaningful but small compared with the dominant residential per-diem and day habilitation lines, reinforcing the provider's specialization in long-stay and structured habilitation supports.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	13,780	$7,530	$103.7M
T2021	Day habilitation, waiver; per 15 minutes	21,190	$1,150	$24.4M
T2017	Habilitation, residential, waiver; 15 minutes	5,460	$1,390	$7.6M
T2020	Day habilitation, waiver; per diem	3,570	$1,040	$3.7M
T2003	Non-emergency transportation; encounter/trip	9,280	$340	$3.2M
T2022	Case management, per month	12,740	$160	$2M
T1005	Respite care services, up to 15 minutes	1,340	$650	$863.1K
T1002	Rn services, up to 15 minutes	1,960	$190	$366K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	360	$140	$48.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	380	$100	$36.3K

Showing 1–10 of 12

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

West Bay Residential Services Inc. — 1 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	5	20	6,780	$1,890	$39.8M
T2017	Habilitation, residential, waiver; 15 minutes	15	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	10	30	12,340	$410	$10M
S5125	Attendant care services; per 15 minutes	79	80	13,620	$120	$7.8M
T1005	Respite care services, up to 15 minutes	13	20	2,540	$190	$1.4M
T2022	Case management, per month	7	40	5,460	$150	$1.2M
T2003	Non-emergency transportation; encounter/trip	24	60	7,480	$80	$1.1M
T2020	Day habilitation, waiver; per diem	1	20	450	$950	$864.4K
T2019	Habilitation, supported employment, waiver; per 15 minutes	14	10	1,870	$230	$688.6K
T1002	Rn services, up to 15 minutes	5	30	280	$110	$253.3K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as West Bay Residential Services Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
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

West Bay Residential Services Inc. — Billing Profile & Reimbursement Data

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West Bay Residential Services 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