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.

City Of Providence Rhode Island (NPI 1366570384)

Field	Value
Entity Type	Organization
Organization	City Of Providence Rhode Island
Address	797 Westminster St
City	Providence
State	RI
ZIP	02903
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	March 1, 2007

Payer Source	Total Paid
Medicaid	$18.6M
Medicare	$0

Key Findings

CITY OF PROVIDENCE RHODE ISLAND is effectively a single-payer Medicaid provider with no Medicare billing on file and a lifetime Medicaid revenue of $18.6M, indicating its operations and reimbursement footprint are concentrated entirely within Medicaid programs rather than Medicare. The absence of Medicare revenue means analyses of Medicare-facing service lines or national Medicare competitive standing are not applicable for this entity.

Revenue is highly concentrated in a small set of service codes: the platform’s precomputed top-3 Medicaid codes account for 84.4% of the provider’s total Medicaid revenue, showing a heavy reliance on a narrow set of billable services for most of its Medicaid income. This concentration implies that changes in reimbursement policy, utilization review, or state coverage for those few codes could materially affect overall revenue.

The single largest revenue driver is S5125 (Attendant care services; per 15 minutes), which generates $11.1M or 59.7% of the provider’s Medicaid revenue. CITY OF PROVIDENCE ranks #11 of 83 in-state for S5125 (88th percentile), a volume described as typical/unremarkable for this code, which suggests the provider has substantial attendant-care operations but is not an extreme statewide outlier for that specific service.

Two additional codes are extreme outliers in-state and together make up a large share of remaining Medicaid revenue: X0215 (159.4K claims, $2.4M; ranks #1 of 26, 100th percentile) and 92508 (200.4K claims, $2.2M; ranks #1 of 50, 100th percentile). These rank positions and the characterization “extreme outlier” indicate CITY OF PROVIDENCE performs exceptionally high volumes of these services relative to peers, signaling specialized scale in the activities those codes represent (92508 is group treatment for communication/hearing impairments; X0215 has no description provided).

The service mix (dominant S5125 attendant care plus very large volumes of 92508 group speech/hearing services and X0215) points to an operational model focused on long-duration, per-15-minute direct care and high-volume group therapy or support services, consistent with an educational/local agency delivering in-school or community-based supportive services. The presence of 97150 and 97110 among top codes (supervised group therapeutic procedures and therapeutic exercise) further supports a focus on therapy and rehabilitative group care.

Several additional codes show volumes that are notably above typical state peers: 97150 (79.5K claims, $874.7K; ranks #1 of 48, 100th percentile), 97110 (33.2K claims, $530.8K; ranks #5 of 360, 99th percentile), 96153 ($347.4K; ranks #2 of 23, 95th percentile), 92507 ($303K; ranks #3 of 72, 97th percentile), and T2003 ($212.3K; ranks #2 of 55, 98th percentile). These placements indicate the provider is a major in-state deliverer of therapy, assessment, and non-emergency transportation encounters relative to most peers.

From a competitive-standing perspective within Rhode Island, CITY OF PROVIDENCE is a dominant or top-ranked provider for multiple Medicaid codes (several #1 ranks and multiple 100th–99th percentiles), making it a meaningful in-state player for school-based and community therapy services even while its S5125 volume is more typical. Analysts should treat this entity as a locally significant provider for specialized therapy and attendant-care bundles.

The NPI was enumerated around 2007-03-01 (~19 years ago), which indicates a long-tenured presence in Medicaid billing and likely established operational workflows and provider relationships; this tenure supports interpreting high-volume patterns as sustained service delivery rather than a new entrant surge.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	158,310	$70	$11.1M
X0215	N/A	159,440	$20	$2.4M
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	200,370	$10	$2.2M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	79,520	$10	$874.7K
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…	33,170	$20	$530.8K
96153	N/A	23,160	$20	$347.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	18,940	$20	$303K
T1002	Rn services, up to 15 minutes	7,800	$40	$288.6K
H0004	Behavioral health counseling and therapy, per 15 minutes	15,960	$20	$287.3K
T2003	Non-emergency transportation; encounter/trip	70,780	$1	$212.3K

Showing 1–10 of 15

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

City Of Providence Rhode Island — 8 of 14 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	11	80	13,620	$120	$7.8M
T2003	Non-emergency transportation; encounter/trip	2	60	7,480	$80	$1.1M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	1	50	3,100	$50	$372.6K
T1002	Rn services, up to 15 minutes	3	30	280	$110	$253.3K
H0004	Behavioral health counseling and therapy, per 15 minutes	6	80	340	$70	$223.7K
X0215	N/A	1	30	1,870	$20	$213K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	1	50	9,880	$10	$212.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	3	70	2,270	$30	$122.3K
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…	5	360	520	$30	$89.2K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	6	10	140	$180	$72.3K

Showing 1–10 of 15

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rhode Island Hospital	RI	General Acute Care Hospital	$0	$380.8M
Maxim Healthcare Services, Inc.	RI	Home Health Agency	$0	$32.1M
Children's Friend And Service	RI	Voluntary or Charitable Agency	$0	$18.7M
Brown Emergency Medicine	RI	Emergency Medicine Physician	$0	$12.3M
The Providence Center	RI	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.9M
Brown Neurology	RI	Neurology Physician	$0	$9.9M
One Stone L.L.C.	RI	Home Health Agency	$0	$8.6M
Recovery Connection Centers Of America, Inc.	RI	Multi-Specialty Clinic/Center	$0	$7.5M
City Of Providence Rhode Island	RI	Land Ambulance	$917.7K	$6.4M
Lifespan Physician Group, Inc.	RI	General Practice Physician	$0	$5.6M

City Of Providence Rhode Island — 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