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 Colorado for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Colorado 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. Colorado (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.

Foothills Gateway Inc. (NPI 1558484394)

Field	Value
Entity Type	Organization
Organization	Foothills Gateway Inc.
Address	301 Skyway Dr
City	Fort Collins
State	CO
ZIP	80525
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	April 9, 2007

Payer Source	Total Paid
Medicaid	$34.6M
Medicare	$0

Key Findings

FOOTHILLS GATEWAY INC. is effectively a Medicaid-only biller at scale: there is no Medicare billing on file and lifetime Medicaid revenue is $34.6M, making Medicaid the sole payer driving this provider’s billed services. The NPI shows long tenure (enumerated 2007-04-09, ~19 years ago), indicating an established presence in Colorado’s waiver and habilitation market.

Revenue is highly concentrated in a few waiver habilitation codes: the top three Medicaid codes (T2016, T2021, T1017) account for 72.4% of the provider’s total Medicaid revenue. Those three codes individually are T2016 with $13.7M (39.6%), T2021 with $7.8M (22.6%), and T1017 with $3.5M (10.3%), so business performance will be sensitive to changes in reimbursement or authorization policies for these services.

The code mix points to a core business in waiver-based habilitation and support services: T2016 (habilitation, residential, waiver), T2021 (day habilitation, waiver), and T1017 (targeted case management) together imply operations centered on residential supports, day programming, and case management for individuals receiving waiver services. Supplementary codes such as T2015 (prevocational habilitation), T2003 (non-emergency transportation), and multiple respite and personal care codes further indicate on-the-ground service delivery including transportation logistics and in-home supports.

Competitive standing varies by code: the provider is a strong statewide participant for targeted case management (T1017 ranks #24 of 309 providers, in the 93rd percentile) and for day habilitation (T2021 ranks #43 of 290, in the 85th percentile), which suggests market leadership in those service lines; by contrast, T2016 (residential habilitation) is mid-ranked (#104 of 191, 46th percentile), reflecting more modest share in the residential habilitation space. The dataset characterizes many of these volumes as "typical, unremarkable volume for this code," indicating the provider’s activity often falls within expected ranges for in-state peers despite high ranks on some codes.

There are identifiable niche services and ancillary revenue streams beyond the core three codes: S8940 (equestrian/hippotherapy) appears with $263.8K revenue and ranks #1 of 8 providers in-state (100th percentile), and T2003 (non-emergency transportation) contributes $2.2M (6.5%) from 18.5K claims. These items show FOOTHILLS GATEWAY operates both specialized therapeutic offerings and high-volume transport services, diversifying revenue beyond residential and day habilitation.

Several codes show a high percentile rank but are still described in the data as typical volumes, which signals that high rank may reflect a small or specialized peer set rather than unusually intense utilization. Examples include T2015 (ranks #5 of 17, 75th percentile) and T2035 (ranks #2 of 5, 75th percentile); S8940 is ranked #1 of 8 (100th percentile) even while its label remains "typical, unremarkable volume for this code," suggesting specialization within limited competition.

Operational and business risk is concentrated: with 72.4% of Medicaid revenue coming from T2016, T2021, and T1017, any policy, authorization, or rate changes affecting waiver habilitation or case management services could materially affect the provider’s revenue. Given the provider’s long tenure (~19 years) and the mix of residential, day, and transport services, payer negotiations or program changes tied to waiver services should be prioritized in competitor or risk assessments.

Beyond the revenue concentration, FOOTHILLS GATEWAY shows breadth in service delivery across waiver support categories—personal care, respite (S5150/S5151), activity therapy (G0176), and equipment/supplies (T2028/T2035)—but these collectively represent much smaller shares of the $34.6M Medicaid total. Most of these secondary codes are also documented as "typical, unremarkable volume for this code," indicating the provider’s secondary services align with normal in-state expectations rather than representing outlier activity.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	3,180	$4,310	$13.7M
T2021	Day habilitation, waiver; per 15 minutes	26,110	$300	$7.8M
T1017	Targeted case management, each 15 minutes	19,080	$190	$3.5M
T2015	Habilitation, prevocational, waiver; per hour	4,780	$640	$3M
T2003	Non-emergency transportation; encounter/trip	18,490	$120	$2.2M
S5130	Homemaker service, nos; per 15 minutes	2,670	$280	$742.3K
T2019	Habilitation, supported employment, waiver; per 15 minutes	4,900	$110	$524.5K
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…	1,890	$250	$472.8K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	1,510	$240	$364.6K
S5150	Unskilled respite care, not hospice; per 15 minutes	1,200	$300	$358.2K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.

Claims Volume vs. Colorado Distribution

Foothills Gateway Inc. — 1 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	104	190	3,890	$290	$12.4M
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…	333	480	5,200	$150	$3.5M
T2021	Day habilitation, waiver; per 15 minutes	43	290	3,700	$160	$2.3M
T2019	Habilitation, supported employment, waiver; per 15 minutes	35	100	1,940	$200	$1.5M
S5130	Homemaker service, nos; per 15 minutes	190	340	3,530	$80	$1.2M
S5150	Unskilled respite care, not hospice; per 15 minutes	46	90	1,540	$130	$1M
T2003	Non-emergency transportation; encounter/trip	53	280	2,640	$20	$881.3K
H2019	Therapeutic behavioral services, per 15 minutes	57	100	1,090	$90	$600.8K
T2015	Habilitation, prevocational, waiver; per hour	5	20	1,670	$120	$578.5K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	18	40	1,400	$110	$566.3K

Showing 1–10 of 22

Nearby Providers

Other providers in the same ZIP code as Foothills Gateway Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mosaic	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$40.1M
Rocky Mountain Clinics LLC	CO	Clinical Medical Laboratory	$0	$13.1M
Foothills Gateway, Inc.	CO	Case Manager/Care Coordinator	$0	$10.8M
Svc Dental Group, LLC	CO	Pediatric Dentistry	$0	$8.4M
Summitstone Health Partners	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.4M
The Residence At Oakridge, LLC	CO	Assisted Living Facility	$0	$6.9M
Fort Collins Radiologic Associates PC	CO	Diagnostic Radiology Physician	$0	$6.4M
Reyes Corporation	CO	Community/Behavioral Health Agency	$0	$5.2M
Highpointe Services	CO	Developmentally Disabled Services Day Training Agency	$0	$5.1M
Alexander Home Healthcare LLC	CO	In Home Supportive Care Agency	$0	$3.8M

Foothills Gateway 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