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 1710273370)

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	$35.5M
Medicare	$0

Key Findings

THE FOGARTY CENTER has no Medicare billing on file and reports $35.5M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) operation at the scale shown in these records. This concentration in Medicaid shapes both its service mix and financial exposure.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 93.0% of the provider's total Medicaid revenue, with T2033 at $25.8M (72.5%), T2021 at $5.9M (16.6%), and T2003 at $1.4M (3.9%). This narrow set of codes drives nearly the entire Medicaid footprint reported here.

The code mix signals a core business built around residential and habilitation services: T2033 (residential care, waiver; per diem) dominates revenue and, with an average paid/claim of $6148, aligns with a high-cost residential care model. T2021 (day habilitation, waiver; per 15 minutes) at $5.9M and an $878 avg paid/claim indicates a substantial day habilitation program, while T2003 (non-emergency transportation) reflects operational support services that enable participation in those programs.

Despite large absolute revenue in T2033, THE FOGARTY CENTER is not a statewide leader on its top codes: T2033 ranks #17 of 22 providers in-state (24th percentile), T2021 ranks #21 of 33 (38th percentile), and T2003 ranks #37 of 55 (33rd percentile). These ranks indicate typical or unremarkable volume relative to in-state peers rather than market dominance.

There are several smaller, complementary revenue lines that provide limited diversification: T2017 (habilitation, residential; $1.2M, 3.4%), T2020 (day habilitation, per diem; $541.5K, 1.5%), and T2022 (case management; $540K, 1.5%) together account for additional programmatic services but remain minor compared with the top two codes. The presence of T1002 (RN services; $117.9K) suggests some billed clinical nursing activity, though at low claim counts.

Average paid-per-claim levels suggest the economics of care delivery are driven by a few high-dollar encounters: T2033’s $6148 avg paid/claim and T1002’s $1092 avg paid/claim contrast with per-15-minute rates for T2021 ($878 avg paid/claim), underscoring that per-diem residential funding is the primary revenue engine. Analysts should note these per-claim differences when modeling margin sensitivity across service lines.

The provider’s NPI was enumerated on 2011-06-22 (~15 years ago), indicating a sustained presence in the market that could reflect stable contract relationships with Medicaid. Tenure supports the plausibility of established program operations rather than a recent entrant profile.

Given the extreme revenue concentration in T2033 (72.5% of Medicaid revenue), the organization faces material exposure to reimbursement or policy changes affecting residential waiver per-diem payments; monitoring state waiver rates and utilization trends for T2033 should be a priority for payers and analysts assessing financial and network risk.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	4,190	$6,150	$25.8M
T2021	Day habilitation, waiver; per 15 minutes	6,730	$880	$5.9M
T2003	Non-emergency transportation; encounter/trip	3,950	$350	$1.4M
T2017	Habilitation, residential, waiver; 15 minutes	1,080	$1,130	$1.2M
T2020	Day habilitation, waiver; per diem	600	$900	$541.5K
T2022	Case management, per month	3,270	$170	$540K
T1002	Rn services, up to 15 minutes	110	$1,090	$117.9K
T2015	Habilitation, prevocational, waiver; per hour	300	$190	$56.8K
T5999	Supply, not otherwise specified	30	$260	$7.4K

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

The Fogarty Center. — 0 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	17	20	6,780	$1,890	$39.8M
T2017	Habilitation, residential, waiver; 15 minutes	27	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	21	30	12,340	$410	$10M
T2022	Case management, per month	28	40	5,460	$150	$1.2M
T2003	Non-emergency transportation; encounter/trip	37	60	7,480	$80	$1.1M
T2020	Day habilitation, waiver; per diem	6	20	450	$950	$864.4K
T2015	Habilitation, prevocational, waiver; per hour	9	20	330	$460	$396.2K
T1002	Rn services, up to 15 minutes	23	30	280	$110	$253.3K
T5999	Supply, not otherwise specified	7	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	Developmentally Disabled Services Day Training Agency	$0	$224.3M
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	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