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 Arc Of Bristol County Inc. (NPI 1801935176)

Field	Value
Entity Type	Organization
Organization	The Arc Of Bristol County Inc.
Address	36 Thurber Boulevard
City	Smithfield
State	RI
ZIP	02917
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicaid	$27.7M
Medicare	$0

Key Findings

THE ARC OF BRISTOL COUNTY INC. appears to operate primarily as a Medicaid-funded developmental disability services and adult day/foster care organization, with its top revenue codes reflecting long-term per-diem support and habilitation services. The three top Medicaid codes (S5140, S5102, H2014) together account for 94.2% of the provider’s total Medicaid revenue, indicating services are heavily concentrated in foster care/adult per-diem and skills training delivered in programmatic day or residential settings.

Revenue concentration is extreme: S5140 (Foster care, adult; per diem) alone generates $19.9M, which is 71.8% of this provider’s total Medicaid revenue, and when combined with S5102 (Day care services, adult; per diem, $4M) and H2014 (Skills training and development, per 15 minutes, $2.2M) these three codes dominate the $27.7M in lifetime Medicaid revenue. This concentration suggests operational scale built around a small number of high-volume service lines rather than a broad mix of Medicaid billable services.

The provider is effectively single-payer from an operations perspective: there is no Medicare billing on file while Medicaid revenue totals $27.7M, so Medicaid is the sole recorded public payer source driving revenue and utilization patterns for this entity. Analysts should treat this organization as Medicaid-centered in any payer-strategy or network-impact analysis.

Competitive standing by code shows dominance in several state comparisons. THE ARC ranks #1 of 1 providers in-state for S5140 (0th percentile notation reflects lack of comparable peer volume data), and ranks #1 of 33 providers in-state for H2014 where it is described as an "extreme outlier, far above typical state volume for this code," signaling exceptional scale in skills training relative to peers. By contrast, its S5102 volume ranks #7 of 20 providers (68th percentile), indicating that while still significant, its day-care per-diem volume is more typical among Rhode Island providers.

Operational profile implied by the code mix: heavy utilization of per-diem adult foster care and day care codes (S5140, S5102, S5101) combined with high-volume H2014 skills training suggests the organization provides long-duration residential or day programs with frequent, scheduled habilitation and skill-building contacts billed in 15-minute increments. The presence of T1019, T1016, and H0046 at much smaller revenue shares indicates some case management, personal care, and mental health services are also provided but are not primary revenue drivers.

Several codes show typical or modest statewide standing despite overall concentration: T1019 and T2003 rank in mid-to-high percentiles (T2003 at the 83rd percentile) but contribute only small shares of revenue ($577.1K and $280.7K respectively), implying these ancillary services support the core per-diem and skills training operations rather than drive them. Many other listed codes rank in middle percentiles (e.g., T1016 at the 71st percentile, T1024 at the 52nd percentile) and are individually minor contributors to revenue.

Tenure-wise, the provider’s NPI was enumerated on 2007-02-05 (~19 years ago), indicating long-term presence in the market. That longevity, coupled with dominant H2014 volume and a very large S5140 share, suggests established operational capacity to deliver residential/day habilitation services at scale within the state.

From a payer or network-planning perspective, the provider’s Medicaid concentration and state-level dominance on habilitation and foster/adult per-diem codes position it as a strategic partner for Medicaid-managed care organizations seeking capacity in adult developmental disability day/residential services. However, its lack of Medicare presence means it would not be a contender for Medicare-related contracts or aged-coverage strategies.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	272,540	$70	$19.9M
S5102	Day care services, adult; per diem	36,780	$110	$4M
H2014	Skills training and development, per 15 minutes	25,030	$90	$2.2M
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…	5,550	$100	$577.1K
T2003	Non-emergency transportation; encounter/trip	18,720	$20	$280.7K
S5101	Day care services, adult; per half day	3,960	$70	$257.5K
H0046	Mental health services, not otherwise specified	1,240	$140	$172.5K
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	590	$240	$138.4K
T1016	Case management, each 15 minutes	3,440	$40	$134K
S5100	Day care services, adult; per 15 minutes	960	$50	$44.9K

Showing 1–10 of 11

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 Arc Of Bristol County Inc. — 2 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5140	Foster care, adult; per diem	1	10	272,540	$70	$20M
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…	18	30	9,040	$150	$5.7M
S5102	Day care services, adult; per diem	7	20	24,390	$80	$4.1M
T2003	Non-emergency transportation; encounter/trip	10	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	44	90	510	$160	$975K
H0046	Mental health services, not otherwise specified	40	70	2,310	$70	$698K
T1027	Family training and counseling for child development, per 15 minutes	70	90	350	$100	$363.8K
H2014	Skills training and development, per 15 minutes	1	30	1,420	$90	$300.3K
T1016	Case management, each 15 minutes	53	180	400	$20	$230.7K
S5101	Day care services, adult; per half day	1	10	2,250	$40	$96.6K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as The Arc Of Bristol County Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Arc Of Bristol County, Inc	RI	Developmentally Disabled Services Day Training Agency	$0	$27M
The Arc Of Bristol County, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$10.3M
New England Home Therapies, Inc.	RI	Home Infusion Therapy Pharmacy	$0	$669.5K
Smithfield School Department	RI	Local Education Agency (LEA)	$0	$529K
Ocean State Urgent Care Center Of Smithfield LLC	RI	Urgent Care Clinic/Center	$0	$403.1K
John Corsi	RI	Internal Medicine Physician	$48.8K	$95.2K
Peter Brasch	RI	Ophthalmology Physician	$128.7K	$0
William Levin	RI	Cardiovascular Disease Physician	$116K	$6.1K
Dominic Roda	RI	Foot & Ankle Surgery Podiatrist	$105.1K	$5K
Nidhi Sharma	RI	Internal Medicine Physician	$76.5K	$2.2K

The Arc Of Bristol County 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