Compared to Case Management Peers
Total spending distribution among 137 providers in this specialty
This provider's total spending of $127.6M is at the 50th percentile among 137 Case Management providers.
Total Paid
$127.6M
$127,560,167
Total Claims
834K
Beneficiaries
43K
19.4 claims/patient
Avg Cost/Claim
$153
#920 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
A Caring Heart Case Management, Inc. is a Case Management provider based in Wilson, NC. From the 2018–2024 period, this provider received $127.6M in Medicaid payments across 834K claims.
Important Context
- ℹ️This provider appears to operate as a fiscal intermediary or management organization, processing payments on behalf of many individual caregivers. High aggregate billing is expected for this type of entity.
Why This Matters
This provider received $127.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,945 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 13 distinct procedure codes. The top code (T2013 (Habilitation, residential, waiver, per hour)) accounts for 29% of total spending.
$37.6M
250K claims
$150.41
$158.23
Habilitation, residential, waiver, per hour
$37.6M
250K claims · 29.5%
$34.7M
222K claims
$156.69
$150.51
Day habilitation, waiver; per 15 min
$34.7M
222K claims · 27.2%
$25.2M
134K claims
$188.22
$177.54
Habilitation, educational; per 15 min
$25.2M
134K claims · 19.8%
$9.5M
48K claims
$198.04
$321.53
Comprehensive community support services, per 15 min
$9.5M
48K claims · 7.5%
Day habilitation, waiver; per diem
$9.0M
52K claims · 7.0%
$5.4M
73K claims
$74.43
$96.24
Comprehensive community support services, per 15 min
$5.4M
73K claims · 4.3%
$3.4M
21K claims
$165.28
$331.94
Habilitation, residential, waiver; per diem
$3.4M
21K claims · 2.7%
$2.1M
29K claims
$72.14
$84.46
Unskilled respite care, per 15 min
$2.1M
29K claims · 1.6%
$346K
4K claims
$94.05
$119.19
Respite care services, not in the home, per diem
$346K
4K claims · 0.3%
$145K
840 claims
$172.61
$100.49
Ongoing support to maintain employment, per 15 min
$145K
840 claims · 0.1%
Psychotherapy, 30 minutes
$3K
139 claims · 0.0%
Psychiatric diagnostic evaluation
$769
13 claims · 0.0%
Group psychotherapy
$194
24 claims · 0.0%
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