Is EPIC HEALTH SERVICES (PA), LLC flagged for Medicaid fraud?

EPIC HEALTH SERVICES (PA), LLC (NPI: 1326058223) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does EPIC HEALTH SERVICES (PA), LLC bill Medicaid?

EPIC HEALTH SERVICES (PA), LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Home Health provider. Located in BALA CYNWYD, PA.

What is NPI 1326058223?

NPI 1326058223 is the National Provider Identifier for EPIC HEALTH SERVICES (PA), LLC. They are a Home Health provider based in BALA CYNWYD, PA. This NPI is registered with the CMS NPI Registry.

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EPIC HEALTH SERVICES (PA), LLC

Home Health·BALA CYNWYD, PA·NPI: 1326058223Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $104.4M is at the 25th percentile among 322 Home Health providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$104.4M

$104,429,295

Total Claims

299K

Beneficiaries

15K

19.9 claims/patient

Avg Cost/Claim

$350

Monthly Spending Trend

Yearly Spending

2018

$2.8M

-11%

2019

$2.5M

+257%

2020

$9.0M

+172%

2021

$24.3M

-9%

2022

$22.1M

+3%

2023

$22.8M

-8%

2024

$20.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 10 distinct procedure codes. The top code (S9124 (Nursing care, in the home; per hour)) accounts for 43% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

S9124Nursing care, in the home; per hourSee all providers →

$44.4M

88K claims

$506.24

$400.25

1.3×

Normal range

S9124Normal range

Nursing care, in the home; per hour

$44.4M

88K claims · 42.5%

Your Cost: $506.24/claim|Median: $400.25

1.3× median

T1003LPN/LVN services, per 15 minutesSee all providers →

$10.6M

19K claims

$549.36

$24.24

22.7×

Top 10%

T1003Top 10%

LPN/LVN services, per 15 minutes

$10.6M

19K claims · 10.1%

Your Cost: $549.36/claim|Median: $24.24

22.7× median

W1793State-defined waiver serviceSee all providers →

$10.5M

58K claims

$180.78

$170.32

1.1×

Normal range

W1793Normal range

State-defined waiver service

$10.5M

58K claims · 10.1%

Your Cost: $180.78/claim|Median: $170.32

1.1× median

G0156Home health aide services, per visitSee all providers →

$9.3M

39K claims

$240.97

$39.42

6.1×

Top 10%

G0156Top 10%

Home health aide services, per visit

$9.3M

39K claims · 8.9%

Your Cost: $240.97/claim|Median: $39.42

6.1× median

T2025Waiver services, NOS; per 15 minSee all providers →

$8.5M

13K claims

$667.42

$124.39

5.4×

Top 25%

T2025Top 25%

Waiver services, NOS; per 15 min

$8.5M

13K claims · 8.2%

Your Cost: $667.42/claim|Median: $124.39

5.4× median

T1019Personal care services, per 15 minSee all providers →

$8.0M

34K claims

$234.48

$82.47

2.8×

Top 25%

T1019Top 25%

Personal care services, per 15 min

$8.0M

34K claims · 7.6%

Your Cost: $234.48/claim|Median: $82.47

2.8× median

S9122Home health aide or certified nurse, per hourSee all providers →

$5.9M

31K claims

$194.64

$116.67

1.7×

Top 25%

S9122Top 25%

Home health aide or certified nurse, per hour

$5.9M

31K claims · 5.7%

Your Cost: $194.64/claim|Median: $116.67

1.7× median

S9123Nursing care, in the home, by RN, per 15 minutesSee all providers →

$5.3M

13K claims

$393.25

$124.86

3.1×

Top 25%

S9123Top 25%

Nursing care, in the home, by RN, per 15 minutes

$5.3M

13K claims · 5.1%

Your Cost: $393.25/claim|Median: $124.86

3.1× median

T1002RN services, per 15 minutesSee all providers →

$1.3M

2,759 claims

$453.57

$37.42

12.1×

Top 5%

T1002Top 5%

RN services, per 15 minutes

$1.3M

2,759 claims · 1.2%

Your Cost: $453.57/claim|Median: $37.42

12.1× median

T1000Private duty/independent nursing service(s)See all providers →

$592K

1,176 claims

$503.82

$402.76

1.3×

Top 25%

T1000Top 25%

Private duty/independent nursing service(s)

$592K

1,176 claims · 0.6%

Your Cost: $503.82/claim|Median: $402.76

1.3× median

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