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 1790001840)

Field	Value
Entity Type	Organization
Organization	Seven Hills Rhode Island Inc
Address	1 Albion Rd Ste 201
City	Lincoln
State	RI
ZIP	02865
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	April 14, 2010
NPI Deactivated	April 21, 2023

Payer Source	Total Paid
Medicaid	$22M
Medicare	$0

Key Findings

This provider is effectively single-payer: Medicare shows none (no Medicare billing on file) while reported Medicaid revenue totals $22M, indicating all documented claims and payments are driven by Medicaid programs rather than Medicare. The absence of Medicare activity means the provider’s revenue exposure and contracting dynamics will be dominated by state Medicaid rules and waiver programs rather than Medicare fee schedules or Medicare-managed care contracts.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top-3 Medicaid codes account for 97.2% of this provider’s total Medicaid revenue. In particular, T2017 alone contributes $17M (77.0% of Medicaid revenue), making this single code the primary revenue driver and signaling heavy dependence on that service line.

The code mix and claim-level details indicate a waiver-focused habilitation operation: T2017 (T2017 – Habilitation, residential, waiver; 15 minutes) shows 5.6K claims with a $3020 avg paid/claim and $17M revenue, T2021 (Day habilitation, waiver; per 15 minutes) shows 1.7K claims with a $1978 avg paid/claim and $3.4M revenue, and T2022 (Case management, per month) shows 5.9K claims with a $187 avg paid/claim and $1.1M revenue. These patterns are consistent with residential and day habilitation plus monthly case management services commonly offered under waiver programs and align with the provider’s In Home Supportive Care Agency taxonomy.

Market positioning within the state appears modest rather than dominant on its top lines: T2017 ranks #14 of 36 providers in-state (63th percentile) and is described as typical, unremarkable volume for this code, so the provider is a mid-ranked supplier of residential habilitation. T2021 ranks #27 of 33 (19th percentile) and T2022 ranks #20 of 41 (53th percentile), both characterized as typical, unremarkable volume, which together suggest steady participation but not market share leadership across these services.

Smaller ancillary codes further illustrate a concentrated, waiver-centered portfolio rather than broad service diversification: T2025 (Waiver services; nos) generated $462K (2.1% of Medicaid revenue) across 837 claims with a $552 avg paid/claim and ranks #10 of 25 in-state (63th percentile), while T2041 (Supports brokerage, self-directed, waiver; per 15 minutes) generated $147.1K (0.7% of revenue) across 518 claims with a $284 avg paid/claim and ranks #4 of 6 (40th percentile). These streams appear supplemental to the core habilitation and case management activity rather than primary revenue engines.

The provider has an established operational history: NPI enumerated 2010-04-14 (~16 years ago), indicating long-term participation in Medicaid programs and enough tenure to develop relationships within state waiver systems and care networks. That longevity combined with concentrated Medicaid billing suggests an operational focus and experience with waiver-based service delivery.

From a risk and opportunity standpoint, the heavy reliance on T2017 and the 97.2% concentration in the top three codes means revenue is sensitive to reimbursement or policy changes affecting residential habilitation and related waiver rules. At the same time, the consistently labeled “typical, unremarkable volume” rankings across top codes imply the provider operates as a steady, medium-scale participant in the state market rather than as an outlier or high-growth disruptor.

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
T2017	Habilitation, residential, waiver; 15 minutes	5,620	$3,020	$17M
T2021	Day habilitation, waiver; per 15 minutes	1,700	$1,980	$3.4M
T2022	Case management, per month	5,870	$190	$1.1M
T2025	Waiver services; not otherwise specified (nos)	840	$550	$462K
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	520	$280	$147.1K

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 — 0 of 5 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2017	Habilitation, residential, waiver; 15 minutes	14	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	27	30	12,340	$410	$10M
T2025	Waiver services; not otherwise specified (nos)	10	30	620	$70	$1.2M
T2022	Case management, per month	20	40	5,460	$150	$1.2M
T2041	Supports brokerage, self-directed, waiver; per 15 minutes	4	10	580	$300	$1.1M

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
Seven Hills Rhode Island Inc	RI	Developmentally Disabled Services Day Training Agency	$0	$84.1M
Fellowship Health Resources, Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$49.1M
Seven Hills Rhode Island Inc	RI	Multi-Specialty Clinic/Center	$0	$31M
Mohammad Suhail	RI	Internal Medicine Physician	$126.3K	$16M
Seven Hills Rhode Island Inc	RI	Multi-Specialty Clinic/Center	$0	$9.8M
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

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

Nearby Providers

Frequently Asked Questions

References