Agency
Gateway Healthcare, INC.
Gateway Healthcare, INC. was paid $1.31M by Medicaid between Oct 2024 and Nov 2024, across 22 billing codes. Its largest line is T1041, Medicaid certified community behavioral health clinic services, per month — 100% of everything it billed.
33Billing provider infoGATEWAY HEALTHCARE, INC.
PAWTUCKET, RI 02860
PAWTUCKET, RI 02860
33aNPI1063957249assigned 12/27/2016
33bProvider typeCommunity/Behavioral Health Agency
28Total paid$1.31M
24GClaims6,482
24DCodes billed22
24AFirst – last monthOct 2024 – Nov 2024
Compared with peers
Next to other Community/Behavioral Health Agency providers in Rhode Island
Rank by total paid#20 of 51
Median peer was paid$731K
This provider vs. median1.8×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MARKELL, PETER controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2024incomplete | 6,482 | $1.31M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1041 | Medicaid certified community behavioral health clinic services, per month | 100% | 1,420 | 1,361 | $1.31M |
| S9986 | Not medically necessary service (patient is aware that service not medically necessary) | <1% | 613 | 564 | $0.18 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 198 | 148 | $0.00 |
| J1631 | Injection, haloperidol decanoate, per 50 mg | 0% | 56 | 32 | $0.00 |
| 90846 | Family psychotherapy without the patient present, 50 minutes | 0% | 69 | 45 | $0.00 |
| 90785 | 0% | 32 | 30 | $0.00 | |
| H0036 | Community psychiatric support and treatment, per 15 minutesCommunity psychiatric supportive treatment, face-to-face, per 15 minutes | 0% | 2,661 | 1,031 | $0.00 |
| H0046 | Mental health services, not otherwise specified | 0% | 234 | 188 | $0.00 |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 0% | 44 | 13 | $0.00 |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 0% | 182 | 79 | $0.00 |
| H2023 | Supported employment, per 15 minutes | 0% | 23 | 13 | $0.00 |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 0% | 36 | 36 | $0.00 |
10 more codes
| J2426 | Injection, paliperidone palmitate extended release (invega sustenna), 1 mg | 0% | 64 | $0.00 |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 26 | $0.00 |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | 0% | 13 | $0.00 |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 161 | $0.00 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 127 | $0.00 |
| 90847 | Family psychotherapy with the patient present, 50 minutes | 0% | 167 | $0.00 |
| 99213 | Doctor's office visit, returning patient (routine) | 0% | 81 | $0.00 |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 217 | $0.00 |
| J2427 | Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg | 0% | 14 | $0.00 |
| J0401 | Injection, aripiprazole (abilify maintena), 1 mg | 0% | 44 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMARKELL, PETER (EVP & CFO)
| Provider | Location | Paid |
|---|---|---|
| Rhode Island Hospital | Providence, RI | $380.77M |
| The Miriam Hospital | Providence, RI | $138.58M |
| Gateway Healthcare INC | Pawtucket, RI | $122.93M |
| Emma Pendleton Bradley Hospital | Riverside, RI | $37.64M |
| Newport Hospital | Newport, RI | $15.82M |
| Rhode Island Hospital | Providence, RI | $13.22M |
| Lifespan Physician Group, INC. | Warwick, RI | $6.48M |
| Lifespan Physician Group, INC. | Providence, RI | $5.64M |
| Rhode Island Hospital | Providence, RI | $5.32M |
| Emma Pendleton Bradley Hospital | East Providence, RI | $5.03M |
| Lifespan Physician Group INC | Providence, RI | $4.41M |
| Rhode Island Hospital | Providence, RI | $3.97M |
| Newport Hospital | Newport, RI | $3.05M |
| Rhode Island Hospital | East Providence, RI | $2.58M |
| Vna Technicare, INC. | Providence, RI | $2.52M |
| Rhode Island Hospital | Providence, RI | $2.33M |
| Coastal Medical Physicians, INC. | Providence, RI | $1.33M |
| Coastal Medical Physicians, INC. | Providence, RI | $1.20M |
| Gateway Healthcare, INC | Johnston, RI | $1.13M |
| Gateway Healthcare, INC | Charlestown, RI | $731K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.