Innovive Health of Massachusetts LLC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $59.93 per claim for T1502 (Administration of oral, intramuscular, or subcutaneous medication), which is 7.6× the national median of $7.86.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $59.93 per claim for T1502 (Administration of oral, intramuscular, or subcutaneous medication) — 7.6× the national median of $7.86.
Bills $79.53 per claim for T1003 (LPN/LVN services, per 15 minutes) — 3.3× the national median of $24.24.
This is a statistical summary, not an accusation. See our methodology.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $363.5M is at the 75th percentile among 322 Home Health providers.
Total Paid
$363.5M
$363,489,577
Total Claims
6.6M
Beneficiaries
449K
14.7 claims/patient
Avg Cost/Claim
$55
#184 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Innovive Health of Massachusetts LLC is a Home Health provider based in Medford, MA. From the 2018–2024 period, this provider received $363.5M in Medicaid payments across 6.6M claims.
Why This Matters
This provider received $363.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 45,436 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 18 distinct procedure codes. The top code (T1502 (Administration of oral, intramuscular, or subcutaneous medication)) accounts for 76% of total spending.
$274.7M
4.6M claims
$59.93
$7.86
Administration of oral, intramuscular, or subcutaneous medication
$274.7M
4.6M claims · 75.6%
$73.0M
1.6M claims
$46.58
$51.67
Skilled nursing services, home health, per visit, RN
$73.0M
1.6M claims · 20.1%
$8.2M
217K claims
$37.63
$45.50
Skilled nursing services, home health, per visit, LPN
$8.2M
217K claims · 2.2%
$3.1M
119K claims
$25.83
$39.42
Home health aide services, per visit
$3.1M
119K claims · 0.8%
$1.4M
19K claims
$75.11
$124.86
Nursing care, in the home, by RN, per 15 minutes
$1.4M
19K claims · 0.4%
$1.2M
24K claims
$51.18
$67.94
Physical therapy services, home health, per visit
$1.2M
24K claims · 0.3%
RN services, per 15 minutes
$1.2M
14K claims · 0.3%
$455K
9K claims
$52.64
$68.93
Occupational therapy services, home health, per visit
$455K
9K claims · 0.1%
$106K
3K claims · 0.0%
$98K
822 claims · 0.0%
LPN/LVN services, per 15 minutes
$5K
57 claims · 0.0%
$1K
44 claims · 0.0%
$0
1K claims
$0.00
$23.43
Injection, filgrastim-sndz, biosimilar, 1 mcg
$0
1K claims · 0.0%
$0
78 claims · 0.0%
$0
3K claims · 0.0%
$0
16K claims · 0.0%
$0
4K claims · 0.0%
$0
5K claims · 0.0%
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