Agency
Gateway Healthcare INC
Gateway Healthcare INC was paid $122.93M by Medicaid between Jan 2018 and Dec 2024, across 32 billing codes. Its largest line is H0037, Community psychiatric supportive treatment program, per diem — 40% of everything it billed.
33Billing provider infoGATEWAY HEALTHCARE INC
PAWTUCKET, RI 02860
PAWTUCKET, RI 02860
33aNPI1821078932assigned 01/17/2006
33bProvider typeDevelopmentally Disabled Services Day Training Agency
28Total paid$122.93M
24GClaims794,521
24DCodes billed32
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Developmentally Disabled Services Day Training Agency providers in Rhode Island
Rank by total paid#5 of 34
Median peer was paid$22.59M
This provider vs. median5.4×
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 | |
|---|---|---|---|
| 2018 | 98,349 | $13.95M | |
| 2019 | 151,381 | $19.88M | |
| 2020 | 130,732 | $17.81M | |
| 2021 | 138,716 | $19.62M | |
| 2022 | 100,866 | $20.15M | |
| 2023 | 93,577 | $17.71M | |
| 2024incomplete | 80,900 | $13.82M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H0037 | Community psychiatric supportive treatment program, per diem | 40% | 126,342 | 117,067 | $49.44M |
| H0019 | Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem | 27% | 245,654 | 8,450 | $33.27M |
| H0040 | Assertive community treatment program, per diem | 26% | 26,092 | 23,905 | $31.76M |
| H0036 | Community psychiatric support and treatment, per 15 minutesCommunity psychiatric supportive treatment, face-to-face, per 15 minutes | 3.4% | 233,009 | 83,242 | $4.22M |
| H2023 | Supported employment, per 15 minutes | 1.4% | 23,480 | 10,478 | $1.76M |
| S9485 | Crisis intervention mental health services, per diem | <1% | 3,028 | 2,750 | $675K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | <1% | 16,658 | 15,101 | $660K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 12,084 | 5,836 | $569K |
| H2011 | Crisis intervention service, per 15 minutes | <1% | 3,768 | 2,943 | $171K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 3,473 | 3,123 | $113K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 882 | 521 | $79K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 1,155 | 1,068 | $74K |
20 more codes
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 1,317 | $38K |
| 90837 | Psychotherapy session, about an hour | <1% | 2,409 | $27K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | <1% | 96 | $17K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 45 | $12K |
| H0046 | Mental health services, not otherwise specified | <1% | 38,952 | $12K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 938 | $11K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 360 | $7K |
| T1016 | Case management, each 15 minutes | <1% | 48,192 | $5K |
| 90836 | <1% | 45 | $3K | |
| T1027 | Family training and counseling for child development, per 15 minutes | <1% | 61 | $2K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 424 | $2K |
| H2016 | Community support for mental illness or disability, billed per day | <1% | 377 | $1K |
| 99442 | <1% | 65 | $257.50 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 465 | $179.07 |
| J2426 | Injection, paliperidone palmitate extended release (invega sustenna), 1 mg | <1% | 239 | $0.80 |
| H0038 | Self-help/peer services, per 15 minutes | 0% | 3,942 | $0.00 |
| 99441 | 0% | 127 | $0.00 | |
| 99443 | 0% | 420 | $0.00 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 394 | $0.00 |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 28 | $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 |
| 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 |
| Gateway Healthcare, INC. | Pawtucket, RI | $1.31M |
| 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.