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

Assistcarehome Healthcare Services

Home Health·Brooklyn, NY·NPI: 1396051694SharePrint 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:

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

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

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Billing Velocity5079.2 claims/working day

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $218.66 per claim for 99199 (Unlisted special service, procedure, or report) — 40.6× the national median of $5.39.

Bills $125.81 per claim for 90471 (Immunization administration, 1 vaccine, percutaneous/ID/SC/IM) — 12.8× the national median of $9.80.

Billing in the top 1% nationally for 1 procedure code: 90471.

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

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $1.44B is at the 90th percentile among 322 Home Health providers.

Above 90th percentile for this specialty — higher spending than 289 of 322 peers

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

Total Paid

$1.44B

$1,442,353,044

Total Claims

9.4M

Beneficiaries

462K

20.3 claims/patient

Avg Cost/Claim

$154

#14 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Assistcarehome Healthcare Services is a Home Health provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $1.4B in Medicaid payments across 9.4M claims.

Why This Matters

This provider received $1.4B in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 180,294 Medicaid beneficiaries for a full year at average per-enrollee costs.

282% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$68.7M
+106%
2019
$141.3M
+41%
2020
$199.2M
+5%
2021
$210.1M
+27%
2022
$265.9M
+11%
2023
$294.5M
-11%
2024
$262.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 17 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 88% of total spending.

T1019Normal range

Personal care services, per 15 min

$1.27B

8.8M claims · 87.9%

Your Cost: $143.44/claim|Median: $82.47
1.7× median
T1020Normal range

Personal care services, per diem

$168.0M

498K claims · 11.6%

Your Cost: $337.62/claim|Median: $296.27
1.1× median
T1030Top 25%

Nursing care, in the home, by RN, per diem

$3.0M

22K claims · 0.2%

Your Cost: $131.60/claim|Median: $85.62
1.5× median
S9123Normal range

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

$2.5M

19K claims · 0.2%

Your Cost: $130.62/claim|Median: $124.86
1.1× median
T2024Normal range

Supported employment, waiver, per diem

$749K

5K claims · 0.1%

Your Cost: $154.89/claim|Median: $259.38
0.6× median
T1022Normal range

$413K

2K claims · 0.0%

Your Cost: $183.50/claim|Median: $184.03
1.0× median
T1031Top 10%

Nursing care, in the home, by LPN, per diem

$284K

2K claims · 0.0%

Your Cost: $142.08/claim|Median: $80.56
1.8× median
T1001Top 25%

Nursing assessment/evaluation, per visit

$62K

644 claims · 0.0%

Your Cost: $96.26/claim|Median: $49.05
2.0× median
S5130Top 25%

Homemaker service, NOS; per 15 min

$51K

537 claims · 0.0%

Your Cost: $95.87/claim|Median: $48.76
2.0× median
99199Top 5%

Unlisted special service, procedure, or report

$51K

234 claims · 0.0%

Your Cost: $218.66/claim|Median: $5.39
40.6× median
S9131Normal range

Physical therapy, in the home, per diem

$26K

361 claims · 0.0%

Your Cost: $72.92/claim|Median: $90.35
0.8× median
S9127Normal range

Social work visit, in the home, per diem

$20K

208 claims · 0.0%

Your Cost: $97.84/claim|Median: $98.75
1.0× median
S9122Normal range

Home health aide or certified nurse, per hour

$18K

227 claims · 0.0%

Your Cost: $81.37/claim|Median: $116.67
0.7× median
G0162Normal range

Skilled services by RN in home health, per 15 min

$12K

257 claims · 0.0%

Your Cost: $47.89/claim|Median: $59.83
0.8× median
90471Top 1%

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$4K

31 claims · 0.0%

Your Cost: $125.81/claim|Median: $9.80
12.8× median
99080Normal range

$0

819 claims · 0.0%

Your Cost: $0.00/claim|Median: $6.15
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$0

611 claims · 0.0%

Your Cost: $0.00/claim|Median: $37.81