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.

Seven Hills Rhode Island Inc (NPI 1760779045)

Field	Value
Entity Type	Organization
Organization	Seven Hills Rhode Island Inc
Address	1 Albion Rd Ste 201
City	Lincoln
State	RI
ZIP	02865
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	July 7, 2011
NPI Deactivated	April 21, 2023

Payer Source	Total Paid
Medicaid	$84.1M
Medicare	$0

Key Findings

SEVEN HILLS RHODE ISLAND INC has no Medicare billing on file and is effectively a single‑payer Medicaid provider, with total Medicaid revenue of $84.1M. This concentration means the organization’s financial footprint and payer risk are driven almost entirely by Medicaid policy and waiver payment rates.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes (T2033, T2021, T2017) account for 85.8% of the provider’s Medicaid revenue. The single largest line is T2033 with $54.8M (65.1% of Medicaid revenue), followed by T2021 with $12.1M (14.4%) and T2017 with $5.2M (6.2%).

The code mix indicates an operational focus on residential and habilitation services for people with developmental disabilities rather than outpatient medical care: T2033 is a residential care per diem, T2021 is day habilitation billed per 15 minutes, and T2017 is residential habilitation per 15 minutes. These codes align with the provider’s Developmentally Disabled Services Day Training Agency taxonomy and suggest core capacity in congregate residential care plus daytime habilitation programs.

On competitive standing, SEVEN HILLS is a statewide outlier on T2033 — it ranks #1 of 22 providers and is described as an "extreme outlier, far above typical state volume for this code." That dominant position on the residential per diem code suggests the provider operates materially more residential capacity or bills at much higher volume for this service than any in-state peer.

By contrast, its volumes on other major habilitation codes are typical for the state: T2021 (15.4K claims, $12.1M; ranks #14 of 33, 59th percentile) and T2017 (6.2K claims, $5.2M; ranks #13 of 36, 66th percentile) are characterized as typical, unremarkable volume. This indicates that outside of the residential per diem business, SEVEN HILLS competes as a mid‑tier participant in day and residential habilitation.

There are additional secondary revenue lines that reflect a broader service mix but much smaller shares of total Medicaid revenue: for example, T2020 (per diem day habilitation) generated $4.6M (5.5% of Medicaid revenue) and ranks #3 of 15 providers (86th percentile), while non‑emergency transport T2003 produced $2M (2.4%) and ranks #31 of 55 (44th percentile). These tails show the provider bills across multiple waiver and support codes, but none approach the scale of T2033.

The provider’s heavy dependence on a few Medicaid waiver codes creates concentration risk: policy, rate, or eligibility changes affecting T2033, T2021, or T2017 could materially impact aggregate revenue given these three codes together represent 85.8% of Medicaid receipts. Payers and analysts should monitor waiver rule changes, per‑diem rate adjustments, and residential‑capacity shifts when assessing financial stability.

SEVEN HILLS’ NPI was enumerated on 2011-07-07 (~15 years ago), indicating an established multi‑year presence in the state. State ranking information across many codes (e.g., presence in top lists for T2021, T2017, T2020, T2003 and various case management and personal care codes) shows the organization operates a diversified service menu within developmental‑disability waivers even though revenue is concentrated in a small number of lines.

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	151,270	$360	$54.8M
T2021	Day habilitation, waiver; per 15 minutes	15,400	$790	$12.1M
T2017	Habilitation, residential, waiver; 15 minutes	6,160	$850	$5.2M
T2020	Day habilitation, waiver; per diem	2,450	$1,870	$4.6M
T2003	Non-emergency transportation; encounter/trip	5,340	$380	$2M
T2022	Case management, per month	11,200	$140	$1.6M
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…	10,470	$90	$921K
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	7,060	$120	$875.8K
T2019	Habilitation, supported employment, waiver; per 15 minutes	930	$510	$472.8K
T1027	Family training and counseling for child development, per 15 minutes	3,260	$100	$319.3K

Showing 1–10 of 23

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

Seven Hills Rhode Island Inc — 1 of 23 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	1	20	6,780	$1,890	$39.8M
T2017	Habilitation, residential, waiver; 15 minutes	13	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	14	30	12,340	$410	$10M
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…	13	30	9,040	$150	$5.7M
T1005	Respite care services, up to 15 minutes	14	20	2,540	$190	$1.4M
T2025	Waiver services; not otherwise specified (nos)	13	30	620	$70	$1.2M
T2022	Case management, per month	11	40	5,460	$150	$1.2M
T2003	Non-emergency transportation; encounter/trip	31	60	7,480	$80	$1.1M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	22	90	510	$160	$975K
T2020	Day habilitation, waiver; per diem	3	20	450	$950	$864.4K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Seven Hills Rhode Island Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seven Hills Rhode Island Inc	RI	Multi-Specialty Clinic/Center	$0	$31M
Seven Hills Rhode Island Inc	RI	Multi-Specialty Clinic/Center	$0	$9.8M
Seven Hills Rhode Island Inc	RI	Adult Day Care Clinic/Center	$0	$1.3M

Nearby Providers

Other providers in the same ZIP code as Seven Hills Rhode Island Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fellowship Health Resources, Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$49.1M
Seven Hills Rhode Island Inc	RI	In Home Supportive Care Agency	$0	$22M
Mohammad Suhail	RI	Internal Medicine Physician	$126.3K	$16M
Caregivers Ri, LLC	RI	Home Health Agency	$0	$8.5M
Epoch Sleep Centers, LLC	RI	Sleep Disorder Diagnostic Clinic/Center	$88.3K	$3.8M
Anchor Medical Associates	RI	General Practice Physician	$0	$2.9M
Golden Roads Adult Day Center LLC	RI	Adult Day Care Clinic/Center	$0	$2.3M
Town Of Lincoln Public Schools	RI	Local Education Agency (LEA)	$0	$2.1M
Anchor Counseling Center	RI	Clinical Social Worker	$0	$2.1M
Seven Hills Rhode Island Inc	RI	Case Management Agency	$0	$1.8M

Seven Hills Rhode Island Inc — Billing Profile & Reimbursement Data

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Seven Hills Rhode Island 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

Related Providers

Nearby Providers

Frequently Asked Questions

References