Lutheran Family Services of Virginia Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $8,070.26 per claim for T2033 (Residential care, NOS; per diem), which is 7.7× the national median of $1,051.57.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 4 procedure codes: T2033 at 7.7× median, H2022 at 26.6× median.
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
▼
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.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $8,070.26 per claim for T2033 (Residential care, NOS; per diem) — 7.7× the national median of $1,051.57.
Bills $8,946.31 per claim for H2022 (Community-based wrap-around services, per diem) — 26.6× the national median of $336.31.
Bills $3,959.86 per claim for H2014 (Skills training & development, per 15 min) — 47.2× the national median of $83.88.
Billing in the top 1% nationally for 2 procedure codes: H2014, 97150.
This is a statistical summary, not an accusation. See our methodology.
Compared to Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities Peers
Total spending distribution among 19 providers in this specialty
This provider's total spending of $194.3M is at the 75th percentile among 19 Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities providers.
Total Paid
$194.3M
$194,342,716
Total Claims
32K
Beneficiaries
31K
1.1 claims/patient
Avg Cost/Claim
$6K
#476 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Lutheran Family Services of Virginia Inc. is a Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities provider based in Lynchburg, VA. From the 2018–2024 period, this provider received $194.3M in Medicaid payments across 32K claims.
Why This Matters
This provider received $194.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,292 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 7 distinct procedure codes. The top code (T2033 (Residential care, NOS; per diem)) accounts for 79% of total spending.
$153.4M
19K claims
$8,070.26
$1,051.57
Residential care, NOS; per diem
$153.4M
19K claims · 78.9%
$22.3M
2K claims
$8,946.31
$336.31
Community-based wrap-around services, per diem
$22.3M
2K claims · 11.5%
$14.0M
4K claims
$3,959.86
$83.88
Skills training & development, per 15 min
$14.0M
4K claims · 7.2%
$4.2M
4K claims
$1,080.54
$12.12
Therapeutic procedure, group (2+ patients)
$4.2M
4K claims · 2.2%
$253K
875 claims
$288.81
$150.51
Day habilitation, waiver; per 15 min
$253K
875 claims · 0.1%
$87K
1K claims
$81.26
$400.25
Nursing care, in the home; per hour
$87K
1K claims · 0.0%
$78K
2K claims
$50.66
$124.86
Nursing care, in the home, by RN, per 15 minutes
$78K
2K claims · 0.0%
Other Top Providers in Virginia
View all →Virginia Commonwealth University Health System Authority
General Acute Care Hospital
$658.5M
Rector & Visitors of the University of Virginia
General Acute Care Hospital
$500.5M
Wall Residences LLC
Community Based Residential Treatment Facility In
$481.6M
Home Care Delivered, Inc.
Durable Medical Equipment & Medical Supplies
$309.5M
Childrens Hospital of the Kings Daughters INC
Social Worker, Clinical
$288.2M
Similar Providers
Other top providers in Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities