Kelsch Associates
Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities
Woodbury Heights, New Jersey
NPI: 1235574617
Risk Tier
High
Total Paid
$117.4M
$117,431,259
Total Claims
97K
Beneficiaries
14K
Avg Cost/Claim
$1,207.99
Statistical Risk Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $1,421.37 per claim for H2016 (Comprehensive community support services, per 15 min), which is 4.4× the national median of $321.53.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T2021 (2 unique codes).
Advanced Detection Signals
Suspicious Concentration
Herfindahl-Hirschman Index of 1 across 2 procedure codes — billing is highly concentrated in very few services.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024