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.

Gateways To Change, Inc. (NPI 1881728566)

Field	Value
Entity Type	Organization
Organization	Gateways To Change, Inc.
Address	11 Knight St
City	Warwick
State	RI
ZIP	02886
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	March 15, 2007

Payer Source	Total Paid
Medicaid	$54.5M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the available data: there is no Medicare billing on file and lifetime Medicaid revenue totals $54.5M, indicating heavy reliance on Medicaid as the primary revenue source. The absence of Medicare activity means analyses of Medicare competitiveness or diversification are not applicable for this entity.

Revenue is highly concentrated: the top three Medicaid codes (T2033, T2021, T2017) account for 89.5% of this provider's total Medicaid revenue. Those three codes together drive the vast majority of the business, so changes in reimbursement or utilization for any of them would disproportionately affect overall revenue.

The code mix indicates a core operation built around developmental‑disability residential and habilitation services: T2033 (Residential care, nos, waiver) is the single largest driver, supported by substantial day habilitation billing under T2021 (Day habilitation, waiver; per 15 minutes) and residential habilitation billed under T2017 (Habilitation, residential, waiver; 15 minutes). Auxiliary services billed include non‑emergency transportation (T2003) and case management (T2022), consistent with a provider that operates residential programs with associated day supports and transport for individuals with developmental disabilities.

T2033 is the dominant revenue source at $33.9M (62.1% of Medicaid revenue) from 4.1K claims with an average paid/claim of $8200, but the provider is not a statewide leader on this code: it ranks #18 of 22 providers in‑state (19th percentile) and is described as reporting typical, unremarkable volume for this code. This combination suggests high business dependence on a single code within a market position that is modest relative to peers.

T2021 generates $12.1M (22.1% of Medicaid revenue) from 14K claims with an average paid/claim of $861 and ranks #16 of 33 in‑state (53th percentile), indicating roughly median participation among peers in day habilitation services. The large claim count paired with a median rank implies the provider operates substantial day‑program capacity but faces typical competitive pressure in that service line.

T2017 contributes $2.9M (5.3% of Medicaid revenue) from 2.2K claims with an average paid/claim of $1276 and ranks #25 of 36 in‑state (31th percentile), indicating only modest statewide presence in residential habilitation minutes. Another residential‑style code, T2016, yields $2.3M from 552 claims with a high average paid/claim of $4244 but ranks #5 of 5 in‑state (0th percentile) and is still characterized as typical, unremarkable volume; together these patterns point to mixed intensity across different residential payment structures.

Other billed services are relatively small contributors: T2003 (Non‑emergency transportation) produced $2.4M (4.4% of Medicaid revenue) from 4.6K claims and ranks #36 of 55 in‑state (35th percentile), while T2022 (Case management) produced $873.8K (1.6%) from 5.5K claims and sits at the 50th percentile; both are consistent with supporting services for a residential/habilitation provider rather than primary revenue drivers.

Competitive standing across the measured codes is generally modest: most top codes are described as typical, unremarkable volume and ranks fall in lower to middle percentiles (for example, 19th percentile for T2033, 53th for T2021, 31th for T2017). Combined with the $54.5M Medicaid concentration and no Medicare activity, this profile points to a well‑established but not dominant in‑state operator in developmental‑disability residential and habilitation services.

The provider has a long tenure in the NPI file, enumerated on 2007-03-15 (~19 years ago), which suggests an established operating history in Medicaid programs; given the heavy Medicaid concentration and the specific service mix, analysts should model exposure to state waiver policy and per‑diem/15‑minute rate changes as primary business risks.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	4,130	$8,200	$33.9M
T2021	Day habilitation, waiver; per 15 minutes	14,020	$860	$12.1M
T2017	Habilitation, residential, waiver; 15 minutes	2,250	$1,280	$2.9M
T2003	Non-emergency transportation; encounter/trip	4,560	$530	$2.4M
T2016	Habilitation, residential, waiver; per diem	550	$4,240	$2.3M
T2022	Case management, per month	5,460	$160	$873.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	400	$90	$37.8K
T1002	Rn services, up to 15 minutes	230	$110	$24.8K

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

Gateways To Change, Inc. — 0 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2033	Residential care, not otherwise specified (nos), waiver; per diem	18	20	6,780	$1,890	$39.8M
T2017	Habilitation, residential, waiver; 15 minutes	25	40	3,820	$510	$10.6M
T2021	Day habilitation, waiver; per 15 minutes	16	30	12,340	$410	$10M
T2016	Habilitation, residential, waiver; per diem	5	10	2,050	$1,830	$5M
T2022	Case management, per month	21	40	5,460	$150	$1.2M
T2003	Non-emergency transportation; encounter/trip	36	60	7,480	$80	$1.1M
T1002	Rn services, up to 15 minutes	14	30	280	$110	$253.3K
H0004	Behavioral health counseling and therapy, per 15 minutes	36	80	340	$70	$223.7K

Nearby Providers

Other providers in the same ZIP code as Gateways To Change, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M
J.arthur Trudeau Memorial Home Based Therapy Services	RI	Community/Behavioral Health Agency	$0	$20.3M

Gateways To Change, Inc. — Billing Profile & Reimbursement Data

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Gateways To Change, 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