Is ALBERTA PROFESSIONAL SERVICES flagged for Medicaid fraud?

ALBERTA PROFESSIONAL SERVICES (NPI: 1194969998) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ALBERTA PROFESSIONAL SERVICES bill Medicaid?

ALBERTA PROFESSIONAL SERVICES received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Respite Care provider. Located in GREENSBORO, NC.

What is NPI 1194969998?

NPI 1194969998 is the National Provider Identifier for ALBERTA PROFESSIONAL SERVICES. They are a Respite Care provider based in GREENSBORO, NC. This NPI is registered with the CMS NPI Registry.

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ALBERTA PROFESSIONAL SERVICES

Respite Care·GREENSBORO, NC·NPI: 1194969998Share

Compared to Respite Care Peers

Total spending distribution among 8 providers in this specialty

P25MedianP75P90

This provider's total spending of $57.9M is at the 25th percentile among 8 Respite Care providers.

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

Total Paid

$57.9M

$57,873,230

Total Claims

320K

Beneficiaries

19K

16.5 claims/patient

Avg Cost/Claim

$181

Monthly Spending Trend

Yearly Spending

2018

$7.3M

-7%

2019

$6.8M

+6%

2020

$7.2M

+9%

2021

$7.9M

+15%

2022

$9.1M

+17%

2023

$10.7M

-17%

2024

$8.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 27% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2016Comprehensive community support services, per 15 minSee all providers →

$15.8M

57K claims

$280.16

$321.53

0.9×

Normal range

H2016Normal range

Comprehensive community support services, per 15 min

$15.8M

57K claims · 27.4%

Your Cost: $280.16/claim|Median: $321.53

0.9× median

T2020Day habilitation, waiver; per diemSee all providers →

$13.4M

57K claims

$235.20

$87.34

2.7×

Top 25%

T2020Top 25%

Day habilitation, waiver; per diem

$13.4M

57K claims · 23.1%

Your Cost: $235.20/claim|Median: $87.34

2.7× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$8.0M

55K claims

$145.73

$150.51

1.0×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$8.0M

55K claims · 13.9%

Your Cost: $145.73/claim|Median: $150.51

1.0× median

T2013Habilitation, residential, waiver, per hourSee all providers →

$6.3M

38K claims

$165.23

$158.23

1.0×

Normal range

T2013Normal range

Habilitation, residential, waiver, per hour

$6.3M

38K claims · 10.8%

Your Cost: $165.23/claim|Median: $158.23

1.0× median

H2015Comprehensive community support services, per 15 minSee all providers →

$4.6M

42K claims

$110.06

$96.24

1.1×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$4.6M

42K claims · 8.0%

Your Cost: $110.06/claim|Median: $96.24

1.1× median

T2012Habilitation, educational; per 15 minSee all providers →

$3.9M

25K claims

$154.75

$177.54

0.9×

Normal range

T2012Normal range

Habilitation, educational; per 15 min

$3.9M

25K claims · 6.7%

Your Cost: $154.75/claim|Median: $177.54

0.9× median

S5145Foster care, therapeutic, child, per diemSee all providers →

$3.2M

26K claims

$126.73

$216.31

0.6×

Normal range

S5145Normal range

Foster care, therapeutic, child, per diem

$3.2M

26K claims · 5.6%

Your Cost: $126.73/claim|Median: $216.31

0.6× median

T2014Habilitation, prevocational, waiver, per hourSee all providers →

$951K

4,846 claims

$196.31

$74.75

2.6×

Top 25%

T2014Top 25%

Habilitation, prevocational, waiver, per hour

$951K

4,846 claims · 1.6%

Your Cost: $196.31/claim|Median: $74.75

2.6× median

T2041Supports brokerage, self-directed; per 15 minSee all providers →

$941K

5,767 claims

$163.25

$162.29

1.0×

Normal range

T2041Normal range

Supports brokerage, self-directed; per 15 min

$941K

5,767 claims · 1.6%

Your Cost: $163.25/claim|Median: $162.29

1.0× median

S5150Unskilled respite care, per 15 minSee all providers →

$664K

9,605 claims

$69.17

$84.46

0.8×

Normal range

S5150Normal range

Unskilled respite care, per 15 min

$664K

9,605 claims · 1.1%

Your Cost: $69.17/claim|Median: $84.46

0.8× median

H2025Ongoing support to maintain employment, per 15 minSee all providers →

$13K

133 claims

$96.65

$100.49

1.0×

Normal range

H2025Normal range

Ongoing support to maintain employment, per 15 min

$13K

133 claims · 0.0%

Your Cost: $96.65/claim|Median: $100.49

1.0× median

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