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

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

Gateway Foundation, Inc. (NPI 1568970663)

Field	Value
Entity Type	Organization
Organization	Gateway Foundation, Inc.
Address	1300 Lincoln Ave
City	Jacksonville
State	IL
ZIP	62650
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	January 11, 2018

Payer Source	Total Paid
Medicaid	$3.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0005	Alcohol and/or drug services; group counseling by a clinician	35,360	$90	$3.1M
H0002	Behavioral health screening to determine eligibility for admission to treatment program	1,050	$130	$136.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,040	$110	$113.8K
H2010	Comprehensive medication services, per 15 minutes	460	$30	$13.9K
H0004	Behavioral health counseling and therapy, per 15 minutes	210	$50	$10.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Gateway Foundation, Inc. — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	651	800	2,480	$90	$962.2K
H0005	Alcohol and/or drug services; group counseling by a clinician	15	240	2,810	$60	$602.7K
H2010	Comprehensive medication services, per 15 minutes	149	250	690	$30	$145.6K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	64	330	210	$110	$97.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	65	750	60	$50	$19.9K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Gateway Foundation, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gateway Foundation, Inc.	IL	Substance Use Disorder Rehabilitation Clinic/Center	$0	$8.4M
Aqeel Khan	IL	Psychiatry Physician	$2.2M	$3.5M
Gateway Foundation, Inc.	IL	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.2M
Gateway Foundation, Inc.	IL	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.1M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Physician Services	IL	Rural Health Clinic/Center	$0	$10.7M
Jacksonville School Dist 117	IL	Local Education Agency (LEA)	$0	$3.6M
Lifestar Ambulance Service, Inc.	IL	Ambulance	$649.2K	$2.8M
Air Evac Ems Inc	IL	Air Ambulance	$745.1K	$31K
Kaleigh Albers	IL	Optometrist	$127.7K	$71.4K
Elizabeth Wade	IL	Family Nurse Practitioner	$35.9K	$29.5K

Gateway Foundation, Inc. — Billing Profile & Reimbursement Data

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Gateway Foundation, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References