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.

The Fogarty Center (NPI 1447546007)

Field	Value
Entity Type	Organization
Organization	The Fogarty Center
Address	310 Maple Ave Ste 102
City	Barrington
State	RI
ZIP	02806
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	June 22, 2011

Payer Source	Total Paid
Medicaid	$224.3M
Medicare	$0

Key Findings

THE FOGARTY CENTER is effectively a Medicaid-focused provider with no Medicare billing on file and $224.3M in lifetime Medicaid revenue, indicating its entire billed business in the available data comes from Medicaid programs rather than Medicare. Its NPI was enumerated on 2011-06-22 (~15 years ago), showing it has been an active Medicaid billing entity for a sustained period.

Revenue is highly concentrated in a very small set of service lines: the precomputed top three Medicaid codes account for 93.2% of the provider's total Medicaid revenue, with a single code T2017 alone representing $147.2M (65.6% of Medicaid revenue). This concentration indicates the organization's operations are dominated by a narrow set of habilitation/waiver services rather than a broad mix of Medicaid-funded interventions.

The code mix identifies THE FOGARTY CENTER primarily as a developmental disabilities day and residential habilitation operator: T2017 (Habilitation, residential, waiver), T2021 (Day habilitation, waiver), and T2025 (Waiver services, NOS) together form the revenue base, signaling the provider specializes in long-duration, time-based waiver habilitation services rather than episodic medical procedures or durable medical equipment. That profile is consistent with its taxonomy as a Developmentally Disabled Services Day Training Agency.

Competitive standing within Rhode Island is dominant for several core codes: THE FOGARTY CENTER ranks #1 of 36 providers for T2017 and #1 of 33 for T2021 (both 100th percentile and labeled extreme outliers), and it also ranks #1 of 41 for T2022 (also 100th percentile). These rankings indicate it is a major statewide provider for both residential and day habilitation waiver services, operating at volumes far above typical state peers.

Some ancillary Medicaid codes show typical or unremarkable participation despite the provider’s dominance in core habilitation codes: T2025 ranks #3 of 25 providers (92th percentile) and is described as typical/unremarkable, while smaller-volume supply and nursing codes such as T1999, T1002, and T5999 also reflect modest revenue contributions and routine state-level participation. This suggests THE FOGARTY CENTER focuses its scale on core habilitation programs and offers other ancillary services at expected levels.

The extreme concentration in a few high-volume waiver codes (T2017 at $147.2M and T2021 at $50.8M) creates operational and reimbursement sensitivity: changes in state waiver policy, rate-setting, or utilization management for these specific codes would likely disproportionately affect the provider’s total Medicaid revenue. Given 93.2% of revenue is tied to the top three codes, business risk is concentrated in those program areas.

Despite being a single-payer (Medicaid) billing entity in the dataset, the provider demonstrates breadth within waiver service types by billing both residential habilitation (T2017) and day habilitation (T2021) at scale, plus case management (T2022) and supports brokerage (T2041). This mix suggests an integrated service model serving multiple care settings and administrative functions within the waiver population.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2017	Habilitation, residential, waiver; 15 minutes	533,510	$280	$147.2M
T2021	Day habilitation, waiver; per 15 minutes	163,360	$310	$50.8M
T2025	Waiver services; not otherwise specified (nos)	24,680	$440	$11M
T2022	Case management, per month	48,060	$190	$9.3M
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	18,310	$300	$5.6M
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	1,060	$360	$380.9K
T1002	Rn services, up to 15 minutes	160	$270	$43.6K
T5999	Supply, not otherwise specified	20	$850	$14.5K

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

The Fogarty Center — 5 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2017	Habilitation, residential, waiver; 15 minutes	1	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	1	30	12,340	$410	$10M
T2025	Waiver services; not otherwise specified (nos)	3	30	620	$70	$1.2M
T2022	Case management, per month	1	40	5,460	$150	$1.2M
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	1	10	580	$300	$1.1M
T1002	Rn services, up to 15 minutes	19	30	280	$110	$253.3K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	1	10	170	$350	$127.3K
T5999	Supply, not otherwise specified	9	10	80	$150	$21K

Nearby Providers

Other providers in the same ZIP code as The Fogarty Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Fogarty Center	RI	In Home Supportive Care Agency	$0	$109.9M
The Fogarty Center	RI	Developmentally Disabled Services Day Training Agency	$0	$52.3M
The Fogarty Center.	RI	Developmentally Disabled Services Day Training Agency	$0	$35.5M
The Fogarty Center	RI	Community/Behavioral Health Agency	$0	$9.6M
Barrington Public Schools	RI	Local Education Agency (LEA)	$0	$903.2K
East Bay Pediatric & Adolescent Medicine Associates Inc	RI	Pediatrics Physician	$0	$522.7K
Mark Shannon	RI	Internal Medicine Physician	$0	$486.8K
Rhode Island Cvs Pharmacy, L.L.C.	RI	Pharmacy	$164.6K	$0
Gregory Sadovnikoff	RI	Family Medicine Physician	$137.5K	$10.3K
Town Of Barrington	RI	Ambulance	$98K	$13.3K

The Fogarty Center — Billing Profile & Reimbursement Data

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The Fogarty Center — 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