Is THE FOGARTY CENTER flagged for Medicaid fraud?

THE FOGARTY CENTER (NPI: 1609164144) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does THE FOGARTY CENTER bill Medicaid?

THE FOGARTY CENTER received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Day Training, Developmentally Disabled Services provider. Located in BARRINGTON, RI.

What is NPI 1609164144?

NPI 1609164144 is the National Provider Identifier for THE FOGARTY CENTER. They are a Day Training, Developmentally Disabled Services provider based in BARRINGTON, RI. This NPI is registered with the CMS NPI Registry.

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THE FOGARTY CENTER

Day Training, Developmentally Disabled Services·BARRINGTON, RI·NPI: 1609164144Share

Compared to Day Training, Developmentally Disabled Services Peers

Total spending distribution among 56 providers in this specialty

P25MedianP75P90

This provider's total spending of $52.3M is at the 50th percentile among 56 Day Training, Developmentally Disabled Services providers.

Active Billing Period:2018-01→2024-12(83 months)

Total Paid

$52.3M

$52,312,906

Total Claims

49K

Beneficiaries

32K

1.5 claims/patient

Avg Cost/Claim

$1K

Monthly Spending Trend

Yearly Spending

2018

$6.2M

+3%

2019

$6.4M

-19%

2020

$5.2M

+35%

2021

$7.0M

+12%

2022

$7.9M

+23%

2023

$9.6M

+4%

2024

$10.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 13 distinct procedure codes. The top code (T2033 (Residential care, NOS; per diem)) accounts for 54% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2033Residential care, NOS; per diemSee all providers →

$28.3M

4,889 claims

$5,797.94

$1,051.57

5.5×

Top 10%

T2033Top 10%

Residential care, NOS; per diem

$28.3M

4,889 claims · 54.2%

Your Cost: $5,797.94/claim|Median: $1,051.57

5.5× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$10.3M

20K claims

$518.62

$150.51

3.4×

Top 25%

T2021Top 25%

Day habilitation, waiver; per 15 min

$10.3M

20K claims · 19.7%

Your Cost: $518.62/claim|Median: $150.51

3.4× median

T2017Habilitation, residential, waiver; 15 minSee all providers →

$7.1M

3,963 claims

$1,800.85

$137.32

13.1×

Top 10%

T2017Top 10%

Habilitation, residential, waiver; 15 min

$7.1M

3,963 claims · 13.6%

Your Cost: $1,800.85/claim|Median: $137.32

13.1× median

T2003Non-emergency transport; encounter/tripSee all providers →

$3.5M

7,716 claims

$459.75

$21.70

21.2×

Top 1%

T2003Top 1%

Non-emergency transport; encounter/trip

$3.5M

7,716 claims · 6.8%

Your Cost: $459.75/claim|Median: $21.70

21.2× median

T2019Habilitation, prevocational, waiver; per 15 minSee all providers →

$1.3M

2,363 claims

$559.40

$88.91

6.3×

Top 10%

T2019Top 10%

Habilitation, prevocational, waiver; per 15 min

$1.3M

2,363 claims · 2.5%

Your Cost: $559.40/claim|Median: $88.91

6.3× median

T2022Case management, per monthSee all providers →

$989K

6,596 claims

$149.97

$202.77

0.7×

Normal range

T2022Normal range

Case management, per month

$989K

6,596 claims · 1.9%

Your Cost: $149.97/claim|Median: $202.77

0.7× median

T2015Habilitation, prevocational, waiver, per diemSee all providers →

$298K

2,314 claims

$128.97

$88.27

1.5×

Normal range

T2015Normal range

Habilitation, prevocational, waiver, per diem

$298K

2,314 claims · 0.6%

Your Cost: $128.97/claim|Median: $88.27

1.5× median

T2020Day habilitation, waiver; per diemSee all providers →

$146K

451 claims

$323.60

$87.34

3.7×

Top 10%

T2020Top 10%

Day habilitation, waiver; per diem

$146K

451 claims · 0.3%

Your Cost: $323.60/claim|Median: $87.34

3.7× median

T1002RN services, per 15 minutesSee all providers →

$128K

132 claims

$970.93

$37.42

25.9×

Top 1%

T1002Top 1%

RN services, per 15 minutes

$128K

132 claims · 0.2%

Your Cost: $970.93/claim|Median: $37.42

25.9× median

T2025Waiver services, NOS; per 15 minSee all providers →

$70K

293 claims

$237.96

$124.39

1.9×

Normal range

T2025Normal range

Waiver services, NOS; per 15 min

$70K

293 claims · 0.1%

Your Cost: $237.96/claim|Median: $124.39

1.9× median

T5999Transportation service, not otherwise classifiedSee all providers →

$15K

41 claims

$358.86

$8.13

44.1×

Top 5%

T5999Top 5%

Transportation service, not otherwise classified

$15K

41 claims · 0.0%

Your Cost: $358.86/claim|Median: $8.13

44.1× median

T2023Community transition, waiver; per serviceSee all providers →

$10K

36 claims

$272.60

$300.13

0.9×

Normal range

T2023Normal range

Community transition, waiver; per service

$10K

36 claims · 0.0%

Your Cost: $272.60/claim|Median: $300.13

0.9× median

T1003LPN/LVN services, per 15 minutesSee all providers →

$2K

29 claims

$79.42

$24.24

3.3×

Normal range

T1003Normal range

LPN/LVN services, per 15 minutes

$2K

29 claims · 0.0%

Your Cost: $79.42/claim|Median: $24.24

3.3× median

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The Fogarty Center

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$224.3M

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$182.9M

The Providence Center INC

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$170.8M

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$362.5M

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$337.9M

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$302.3M

The Fogarty Center

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$224.3M

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