Is ELDER SERVICES OF THE MERRIMACK VALLEY, INC. flagged for Medicaid fraud?

ELDER SERVICES OF THE MERRIMACK VALLEY, INC. (NPI: 1174642490) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ELDER SERVICES OF THE MERRIMACK VALLEY, INC. bill Medicaid?

ELDER SERVICES OF THE MERRIMACK VALLEY, INC. received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Home Health provider. Located in LAWRENCE, MA.

What is NPI 1174642490?

NPI 1174642490 is the National Provider Identifier for ELDER SERVICES OF THE MERRIMACK VALLEY, INC.. They are a Home Health provider based in LAWRENCE, MA. This NPI is registered with the CMS NPI Registry.

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ELDER SERVICES OF THE MERRIMACK VALLEY, INC.

Home Health·LAWRENCE, MA·NPI: 1174642490Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $86.3M is at the 25th percentile among 322 Home Health providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$86.3M

$86,287,325

Total Claims

2.8M

Beneficiaries

334K

8.3 claims/patient

Avg Cost/Claim

$31

Monthly Spending Trend

Yearly Spending

2018

$10.4M

+17%

2019

$12.1M

-15%

2020

$10.2M

+9%

2021

$11.2M

+7%

2022

$12.0M

+29%

2023

$15.5M

-3%

2024

$15.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 18 distinct procedure codes. The top code (S5130 (Homemaker service, NOS; per 15 min)) accounts for 35% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

S5130Homemaker service, NOS; per 15 minSee all providers →

$30.0M

540K claims

$55.59

$48.76

1.1×

Normal range

S5130Normal range

Homemaker service, NOS; per 15 min

$30.0M

540K claims · 34.8%

Your Cost: $55.59/claim|Median: $48.76

1.1× median

T1019Personal care services, per 15 minSee all providers →

$28.2M

600K claims

$46.90

$82.47

0.6×

Normal range

T1019Normal range

Personal care services, per 15 min

$28.2M

600K claims · 32.6%

Your Cost: $46.90/claim|Median: $82.47

0.6× median

S5135Companion care, adult, per diemSee all providers →

$10.9M

324K claims

$33.52

$52.25

0.6×

Normal range

S5135Normal range

Companion care, adult, per diem

$10.9M

324K claims · 12.6%

Your Cost: $33.52/claim|Median: $52.25

0.6× median

T2022Case management, per monthSee all providers →

$4.0M

72K claims

$56.24

$202.77

0.3×

Normal range

T2022Normal range

Case management, per month

$4.0M

72K claims · 4.7%

Your Cost: $56.24/claim|Median: $202.77

0.3× median

S5102Day care services, adult; per 15 minSee all providers →

$3.7M

67K claims

$55.28

$81.10

0.7×

Normal range

S5102Normal range

Day care services, adult; per 15 min

$3.7M

67K claims · 4.3%

Your Cost: $55.28/claim|Median: $81.10

0.7× median

S5161Emergency response system, per monthSee all providers →

$2.3M

88K claims

$26.54

$29.97

0.9×

Normal range

S5161Normal range

Emergency response system, per month

$2.3M

88K claims · 2.7%

Your Cost: $26.54/claim|Median: $29.97

0.9× median

S5170Homemaker service, NOS, per diemSee all providers →

$2.3M

241K claims

$9.41

$19.89

0.5×

Normal range

S5170Normal range

Homemaker service, NOS, per diem

$2.3M

241K claims · 2.6%

Your Cost: $9.41/claim|Median: $19.89

0.5× median

T2003Non-emergency transport; encounter/tripSee all providers →

$2.1M

50K claims

$41.66

$21.70

1.9×

Top 25%

T2003Top 25%

Non-emergency transport; encounter/trip

$2.1M

50K claims · 2.4%

Your Cost: $41.66/claim|Median: $21.70

1.9× median

T1020Personal care services, per diemSee all providers →

$1.4M

778K claims

$1.86

$296.27

0.0×

Normal range

T1020Normal range

Personal care services, per diem

$1.4M

778K claims · 1.7%

Your Cost: $1.86/claim|Median: $296.27

0.0× median

S5165Home modifications, per serviceSee all providers →

$726K

3,962 claims

$183.23

$2,196.32

0.1×

Normal range

S5165Normal range

Home modifications, per service

$726K

3,962 claims · 0.8%

Your Cost: $183.23/claim|Median: $2,196.32

0.1× median

T1023Screening to determine appropriateness of consideration for programSee all providers →

$186K

1,560 claims

$119.11

$106.70

1.1×

Normal range

T1023Normal range

Screening to determine appropriateness of consideration for program

$186K

1,560 claims · 0.2%

Your Cost: $119.11/claim|Median: $106.70

1.1× median

S5101Day care services, adult, per half daySee all providers →

$169K

4,229 claims

$39.89

$66.43

0.6×

Normal range

S5101Normal range

Day care services, adult, per half day

$169K

4,229 claims · 0.2%

Your Cost: $39.89/claim|Median: $66.43

0.6× median

S5175Laundry service, per occasionSee all providers →

$159K

5,282 claims

$30.10

$30.40

1.0×

Normal range

S5175Normal range

Laundry service, per occasion

$159K

5,282 claims · 0.2%

Your Cost: $30.10/claim|Median: $30.40

1.0× median

99339 See all providers →

$75K

1,676 claims

$44.87

$37.37

1.2×

Normal range

99339Normal range

$75K

1,676 claims · 0.1%

Your Cost: $44.87/claim|Median: $37.37

1.2× median

S5160Emergency response system, per monthSee all providers →

$25K

644 claims

$38.54

$38.52

1.0×

Normal range

S5160Normal range

Emergency response system, per month

$25K

644 claims · 0.0%

Your Cost: $38.54/claim|Median: $38.52

1.0× median

T1028Assessment of home, physical & family environmentsSee all providers →

$15K

55 claims

$269.50

$81.30

3.3×

Top 5%

T1028Top 5%

Assessment of home, physical & family environments

$15K

55 claims · 0.0%

Your Cost: $269.50/claim|Median: $81.30

3.3× median

99509Home visit, assistance w/ ADLsSee all providers →

$12K

232 claims

$50.05

$51.71

1.0×

Normal range

99509Normal range

Home visit, assistance w/ ADLs

$12K

232 claims · 0.0%

Your Cost: $50.05/claim|Median: $51.71

1.0× median

A0425Ground mileage, per statute mileSee all providers →

52 claims

$0.00

$23.36

—

Normal range

A0425Normal range

Ground mileage, per statute mile

52 claims · 0.0%

Your Cost: $0.00/claim|Median: $23.36

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