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 1821323940)

Field	Value
Entity Type	Organization
Organization	The Fogarty Center
Address	310 Maple Ave
City	Barrington
State	RI
ZIP	02806
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	October 7, 2009

Payer Source	Total Paid
Medicaid	$109.9M
Medicare	$0

Key Findings

THE FOGARTY CENTER reports no Medicare billing on file and instead has generated $109.9M in lifetime Medicaid revenue, making it effectively a Medicaid-focused provider in this dataset. The absence of Medicare claims indicates the organization’s revenue and operational footprint are concentrated entirely in state-funded or waiver-funded programs rather than fee-for-service Medicare markets.

Revenue concentration is extreme: the top three Medicaid codes together account for 99.1% of the provider’s total Medicaid revenue, and a single code, T1019, represents $91.6M or 83.4% of Medicaid revenue alone. This level of concentration shows that most of the provider’s Medicaid business is driven by one time-/unit-based personal-care line, rather than a broadly diversified code mix.

The code mix — dominated by T1019 (personal care services, per 15 minutes), with S5135 (companion care, per 15 minutes) and T2025 (waiver services NOS) trailing — indicates an operation focused on hands-on in-home supportive and personal-care services billed in small time increments. The prevalence of per-15-minute codes (T1019: 495.2K claims; S5135: 117.4K claims; T2025: 39.2K claims) and the modest average paid/claim levels ($185, $106, $122 respectively) are consistent with a labor-intensive, time-based service model delivering ADL/IADL and companion supports.

Competitive standing by code is concentrated at the top of the state distribution: T1019 ranks #1 of 30 providers in-state (100th percentile) and is described as an extreme outlier, meaning THE FOGARTY CENTER is a dominant statewide supplier of personal care billed under that code. S5135 also ranks #1 of 1 providers in-state (no peer comparison available), which suggests it is the sole reported filer for companion-care under that code in the state dataset, while T2025 ranks #2 of 25 providers (96th percentile) and is characterized as typical in volume relative to peers.

The provider’s claim-level activity underscores scale and throughput: T1019 shows 495.2K claims at an average paid/claim of $185, S5135 shows 117.4K claims at $106 avg paid/claim, and T2025 shows 39.2K claims at $122 avg paid/claim. These high claim counts for time-based codes reinforce that the business model relies on many small, repeat service units rather than fewer high-dollar procedures.

Such strong reliance on a single dominant code creates operational and reimbursement concentration risk: with T1019 accounting for 83.4% of Medicaid revenue and the top three codes totaling 99.1% of Medicaid revenue, shifts in state policy, unit rates, or utilization for those codes would materially affect the provider’s revenue. This concentration also limits evidence of diversified service lines within the Medicaid billing profile.

THE FOGARTY CENTER’s NPI was enumerated on 2009-10-07 (~17 years ago), indicating an established tenure in the market that aligns with the large cumulative claim volumes reported for time-based personal-care services. The longevity in the dataset supports the interpretation that the provider has scaled its Medicaid in-home care operations over multiple years.

A small ancillary revenue stream appears in S9999 (Sales tax) at $1M (0.9% of Medicaid revenue) and 3.1K claims, indicating minor non-service charge activity relative to clinical/service billing lines. Taken together with the absence of Medicare billing, the profile suggests THE FOGARTY CENTER primarily participates in Medicaid and waiver-funded personal and companion care programs rather than cross-payer Medicare service lines.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	495,170	$190	$91.6M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	117,370	$110	$12.4M
T2025	Waiver services; not otherwise specified (nos)	39,180	$120	$4.8M
S9999	Sales tax	3,080	$340	$1M

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 — 3 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	1	10	117,370	$110	$12.5M
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…	1	30	9,040	$150	$5.7M
T2025	Waiver services; not otherwise specified (nos)	2	30	620	$70	$1.2M
S9999	Sales tax	1	10	10	$330	$345.8K

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	Developmentally Disabled Services Day Training Agency	$0	$52.3M
The Fogarty Center.	RI	Developmentally Disabled Services Day Training Agency	$0	$35.5M
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