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.

Emma Pendleton Bradley Hospital (NPI 1659576858)

Field	Value
Entity Type	Organization
Organization	Emma Pendleton Bradley Hospital
Address	1011 Veterans Memorial Pkwy
City	Riverside
State	RI
ZIP	02915
Taxonomy	Psychiatric Hospital
NPI Enumerated	June 18, 2007

Payer Source	Total Paid
Medicaid	$37.6M
Medicare	$0

Key Findings

EMMA PENDLETON BRADLEY HOSPITAL is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and lifetime Medicaid revenue is $37.6M. The absence of Medicare claims limits cross‑payer diversification and means the facility’s public revenue exposure is concentrated in state Medicaid programs.

Medicaid revenue is highly concentrated in a single service line: the precomputed top 3 Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, and H0019 alone is reported as 100.0% of this provider’s total Medicaid revenue. That concentration indicates most of the facility’s billed activity and cashflow derive from a narrow set of Medicaid per‑diem behavioral health services.

The code mix and top revenue driver indicate the facility operates primarily as a long‑term residential behavioral health provider: H0019 corresponds to long‑term residential (non‑medical, non‑acute) behavioral health per diem services, with 77.4K claims and a $486 avg paid/claim. Those volumes and per‑diem payments are consistent with sustained, extended‑stay residential care rather than short‑term acute inpatient or outpatient therapy.

Despite the concentration, the facility is a significant in‑state participant for H0019: H0019 ranks #3 of 25 providers in‑state (92th percentile). The dataset characterizes this standing as a "typical, unremarkable volume for this code," so while the hospital is among the higher‑ranking state providers by this measure, it is not recorded as an extreme statistical outlier.

Other billed codes are immaterial to overall revenue and reflect ancillary activity rather than a second core business line: 87633 appears with 31 claims, a $44 avg paid/claim and $1.4K revenue (reported as 0.0% of total), ranking #8 of 12 providers in‑state (36th percentile; typical, unremarkable volume for this code). This small lab testing footprint suggests occasional diagnostic testing tied to resident care rather than a distinct revenue center.

The provider’s NPI has been enumerated since 2007‑06‑18 (~19 years ago), indicating long tenure in the market. This longevity supports interpretation of the current code mix as an established operational model rather than a short‑term program or transient billing pattern.

Operational and financial sensitivity is concentrated in Medicaid per‑diem reimbursement for residential behavioral health: because H0019 is the dominant revenue driver, policy, rate, or eligibility changes affecting that per‑diem could materially affect the provider’s revenue profile. The lack of Medicare billing and minimal ancillary revenue limits natural hedges against state Medicaid reimbursement shifts.

Benchmarking and competitive comparisons are constrained by the absence of Medicare data and by the state‑level orientation of the available Medicaid ranks. Analysts should rely on the in‑state rank and the provided labels (for example, "typical, unremarkable volume for this code") when assessing competitive standing, and avoid national Medicare comparisons for this entity given the complete lack of Medicare billing on file.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	77,450	$490	$37.6M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	30	$40	$1.4K

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

Emma Pendleton Bradley Hospital — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	3	30	1,530	$360	$9.7M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	8	10	40	$470	$332.3K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Emma Pendleton Bradley Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emma Pendleton Bradley Hospital	RI	Psychiatric Hospital	$0	$5M
Jason Rafferty	RI	Child & Adolescent Psychiatry Physician	$0	$762K
William Lewis-de Los Angeles	RI	Pediatrics Physician	$0	$477.9K
Ingrid Lauer Arnold	RI	Psychiatry Physician	$8.6K	$0

Nearby Providers

Other providers in the same ZIP code as Emma Pendleton Bradley Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
East Bay Community Action Program	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$20.5M
Health Care Connections Nursing Services, Inc	RI	Home Health Agency	$0	$3.6M
City Of East Providence	RI	Local Education Agency (LEA)	$0	$2.2M
East Bay Community Action Program	RI	Community/Behavioral Health Agency	$0	$2.2M
East Bay Community Action Program	RI	Community Health Clinic/Center	$0	$1.5M
Amerita Inc	RI	Home Infusion Therapy Pharmacy	$0	$1.1M
Care Resource, LLC	RI	Home Health Agency	$0	$1.1M
Susie Hu	RI	Nephrology Physician	$30.9K	$911.1K
City Of East Providence	RI	Local Education Agency (LEA)	$0	$768.1K
Victor Neel	RI	Dermatology Physician	$726.1K	$0

Emma Pendleton Bradley Hospital — Billing Profile & Reimbursement Data

Sign up for Emma Pendleton Bradley Hospital — Billing Profile & Reimbursement Data policy alerts

Emma Pendleton Bradley Hospital — Billing Profile & Reimbursement Data

Sign up for Emma Pendleton Bradley Hospital — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References