Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Tempus Unlimited, Inc.

Voluntary or Charitable·Stoughton, MA·NPI: 1164887808SharePrint Report

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:

Single-Code

Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.

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

Billing Velocity4687.5 claims/working day
Change PointBilling shifted 3.6x in 2021-12
ConcentrationHHI: 1 on 2 codes

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Extreme procedure concentration — 95% of all billing flows through just 2 codes (99509, A0170).

This is a statistical summary, not an accusation. See our methodology.

Compared to Voluntary or Charitable Peers

Total spending distribution among 13 providers in this specialty

P25MedianP75P90

This provider's total spending of $290.8M is at the 75th percentile among 13 Voluntary or Charitable providers.

Active Billing Period:2018-012024-12(84 months)

Extreme procedure concentration — 95% of $290.8M billed through just 2 codes

Total Paid

$290.8M

$290,808,661

Total Claims

8.7M

Beneficiaries

962K

9.0 claims/patient

Avg Cost/Claim

$34

#256 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Tempus Unlimited, Inc. is a Voluntary or Charitable provider based in Stoughton, MA. From the 2018–2024 period, this provider received $290.8M in Medicaid payments across 8.7M claims.

Important Context

  • ℹ️This provider is a known fiscal management organization for self-directed care programs. They manage billing on behalf of thousands of individual caregivers, so aggregate billing is high by design. However, the self-directed care category has been identified as fraud-prone by regulators.

Why This Matters

This provider received $290.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 36,351 Medicaid beneficiaries for a full year at average per-enrollee costs.

385% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$15.4M
+8%
2019
$16.6M
+31%
2020
$21.7M
+20%
2021
$26.1M
+147%
2022
$64.4M
+12%
2023
$72.2M
+3%
2024
$74.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 2 distinct procedure codes. The top code (99509 (Home visit, assistance w/ ADLs)) accounts for 95% of total spending.

99509Normal range

Home visit, assistance w/ ADLs

$276.1M

5.9M claims · 94.9%

Your Cost: $46.59/claim|Median: $51.71
0.9× median
A0170Normal range

$14.8M

2.7M claims · 5.1%

Your Cost: $5.39/claim|Median: $3.07
1.8× median