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

Diversified Assessment & Therapy Services

Community/Behavioral Health·Kenova, WV·NPI: 1265782395SharePrint 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.

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

Risk Assessment

Bills $1,595.66 per claim for S5125 (Attendant care services, per 15 min) — 19.4× the national median of $82.34.

Bills $128.31 per claim for T1002 (RN services, per 15 minutes) — 3.4× the national median of $37.42.

Bills $301.93 per claim for T1005 (Respite care services, per 15 minutes) — 4.2× the national median of $71.40.

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

This is a statistical summary, not an accusation. See our methodology.

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $122.7M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$122.7M

$122,668,670

Total Claims

201K

Beneficiaries

71K

2.8 claims/patient

Avg Cost/Claim

$611

#973 of 618K providers by total spending(top 0.2%)

🔍 Analysis

Provider Overview

Diversified Assessment & Therapy Services is a Community/Behavioral Health provider based in Kenova, WV. From the 2018–2024 period, this provider received $122.7M in Medicaid payments across 201K claims.

Why This Matters

This provider received $122.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,333 Medicaid beneficiaries for a full year at average per-enrollee costs.

112% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$9.7M
+13%
2019
$10.9M
+21%
2020
$13.2M
+40%
2021
$18.4M
+32%
2022
$24.4M
+5%
2023
$25.5M
-19%
2024
$20.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 13 distinct procedure codes. The top code (S5125 (Attendant care services, per 15 min)) accounts for 85% of total spending.

S5125Top 5%

Attendant care services, per 15 min

$104.6M

66K claims · 85.2%

Your Cost: $1,595.66/claim|Median: $82.34
19.4× median
T2021Normal range

Day habilitation, waiver; per 15 min

$4.5M

29K claims · 3.7%

Your Cost: $154.53/claim|Median: $150.51
1.0× median
T1002Top 25%

RN services, per 15 minutes

$3.4M

26K claims · 2.8%

Your Cost: $128.31/claim|Median: $37.42
3.4× median
T1005Top 5%

Respite care services, per 15 minutes

$2.4M

8K claims · 1.9%

Your Cost: $301.93/claim|Median: $71.40
4.2× median
G9002Top 25%

Coordinated care fee, maintenance period

$2.3M

11K claims · 1.9%

Your Cost: $212.62/claim|Median: $108.80
1.9× median
A0160Top 5%

$1.9M

8K claims · 1.5%

Your Cost: $229.06/claim|Median: $12.60
18.2× median
T1003Normal range

LPN/LVN services, per 15 minutes

$1.8M

24K claims · 1.4%

Your Cost: $74.31/claim|Median: $24.24
3.1× median
T1016Normal range

Case management, each 15 min

$1.1M

17K claims · 0.9%

Your Cost: $65.01/claim|Median: $49.62
1.3× median
T2024Normal range

Supported employment, waiver, per diem

$369K

6K claims · 0.3%

Your Cost: $64.62/claim|Median: $259.38
0.3× median
92507Normal range

Speech/hearing/language treatment

$204K

3K claims · 0.2%

Your Cost: $63.39/claim|Median: $49.45
1.3× median
97530Top 25%

Therapeutic activities, each 15 min

$116K

1K claims · 0.1%

Your Cost: $82.89/claim|Median: $33.11
2.5× median
A0120Top 25%

Non-emergency mini-bus transport

$72K

2K claims · 0.1%

Your Cost: $42.51/claim|Median: $16.09
2.6× median
T2019Normal range

Habilitation, prevocational, waiver; per 15 min

$7K

46 claims · 0.0%

Your Cost: $148.55/claim|Median: $88.91
1.7× median