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

Centrus Premier Home Care INC

Home Health·Plymouth, MA·NPI: 1194711226SharePrint 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:

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.

High Cost Per Claim

High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.

High Claims Per Patient

High Claims Per Patient means this provider files an unusually high number of claims per individual patient. This could indicate legitimate intensive treatment or a pattern of billing for services not actually rendered.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Bills $321.05 per claim for T1002 (RN services, per 15 minutes) — 8.6× the national median of $37.42.

Bills $255.51 per claim for T1003 (LPN/LVN services, per 15 minutes) — 10.5× the national median of $24.24.

Bills $263.54 per claim for T1004 (Services of a qualified nursing aide, per 15 minutes) — 5.2× the national median of $50.30.

Billing above the 90th percentile for 3 procedure codes simultaneously.

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

P25MedianP75P90

This provider's total spending of $201.0M is at the 50th percentile among 322 Home Health providers.

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

Total Paid

$201.0M

$200,964,429

Total Claims

678K

Beneficiaries

30K

22.7 claims/patient

Avg Cost/Claim

$296

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

🔍 Analysis

Provider Overview

Centrus Premier Home Care INC is a Home Health provider based in Plymouth, MA. From the 2018–2024 period, this provider received $201.0M in Medicaid payments across 678K claims.

Why This Matters

This provider received $201.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,120 Medicaid beneficiaries for a full year at average per-enrollee costs.

97% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$21.5M
-0%
2019
$21.5M
+5%
2020
$22.7M
+13%
2021
$25.6M
+17%
2022
$29.9M
+24%
2023
$37.3M
+14%
2024
$42.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 5 distinct procedure codes. The top code (T1002 (RN services, per 15 minutes)) accounts for 61% of total spending.

T1002Top 10%

RN services, per 15 minutes

$123.4M

384K claims · 61.4%

Your Cost: $321.05/claim|Median: $37.42
8.6× median
T1003Top 25%

LPN/LVN services, per 15 minutes

$71.2M

279K claims · 35.4%

Your Cost: $255.51/claim|Median: $24.24
10.5× median
T1004Top 5%

Services of a qualified nursing aide, per 15 minutes

$3.4M

13K claims · 1.7%

Your Cost: $263.54/claim|Median: $50.30
5.2× median
T1030Top 5%

Nursing care, in the home, by RN, per diem

$2.9M

2K claims · 1.4%

Your Cost: $1,534.84/claim|Median: $85.62
17.9× median
G0299Normal range

Skilled nursing services, home health, per visit, RN

$15K

229 claims · 0.0%

Your Cost: $65.41/claim|Median: $51.67
1.3× median