Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

GATEWAY HEALTHCARE INC

NPI: 1821078932 · PAWTUCKET, RI 02860 · Developmentally Disabled Services Day Training Agency · NPI assigned 01/17/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official MARKELL, PETER controls 20+ related entities in our dataset. Read more

$122.93M
Total Medicaid Paid
794,521
Total Claims
326,964
Beneficiaries
32
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialMARKELL, PETER (EVP & CFO)
NPI Enumeration Date01/17/2006

Related Entities

Other providers sharing the same authorized official: MARKELL, PETER

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 80,900 $13.82M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
H0037 Community psychiatric supportive treatment program, per diem 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 245,654 8,450 $33.27M
H0040 Assertive community treatment program, per diem 26,092 23,905 $31.76M
H0036 Community psychiatric supportive treatment, face-to-face, per 15 minutes 233,009 83,242 $4.22M
H2023 Supported employment, per 15 minutes 23,480 10,478 $1.76M
S9485 Crisis intervention mental health services, per diem 3,028 2,750 $675K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 16,658 15,101 $660K
90834 Psychotherapy, 45 minutes with patient 12,084 5,836 $569K
H2011 Crisis intervention service, per 15 minutes 3,768 2,943 $171K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3,473 3,123 $113K
90847 Family psychotherapy with the patient present, 50 minutes 882 521 $79K
90791 Psychiatric diagnostic evaluation 1,155 1,068 $74K
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 1,317 1,255 $38K
90837 Psychotherapy, 53 minutes with patient 2,409 1,231 $27K
H0004 Behavioral health counseling and therapy, per 15 minutes 96 19 $17K
90792 Psychiatric diagnostic evaluation with medical services 45 45 $12K
H0046 Mental health services, not otherwise specified 38,952 20,982 $12K
90832 Psychotherapy, 30 minutes with patient 938 565 $11K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 360 242 $7K
T1016 Case management, each 15 minutes 48,192 23,993 $5K
90836 45 45 $3K
T1027 Family training and counseling for child development, per 15 minutes 61 14 $2K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 424 309 $2K
H2016 Comprehensive community support services, per diem 377 28 $1K
99442 65 60 $257.50
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 465 333 $179.07
J2426 Injection, paliperidone palmitate extended release (invega sustenna), 1 mg 239 210 $0.80
H0038 Self-help/peer services, per 15 minutes 3,942 2,210 $0.00
99441 127 124 $0.00
99443 420 402 $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 394 385 $0.00
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 28 28 $0.00