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

Caregiver Homes of Massachusetts INC

Case Management

Auburn, Massachusetts

NPI: 1245414721

Risk Tier

Elevated

Total Paid

$598.9M

$598,860,245

Total Claims

7.5M

Beneficiaries

268K

Avg Cost/Claim

$80.23

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (1)

Single-Code

Billing almost exclusively for 1-2 procedure codes despite high total volume.

Bills primarily for code T1028 (2 unique codes).

Advanced Detection Signals

Billing Velocity

4039.1 claims per working day — may exceed physically possible volume for a single provider.

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