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The Arc of Essex County, INC

Respite Care·Livingston, NJ·NPI: 1497136592Share

Compared to Respite Care Peers

Total spending distribution among 8 providers in this specialty

P25MedianP75P90

This provider's total spending of $158.9M is at the 50th percentile among 8 Respite Care providers.

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

Total Paid

$158.9M

$158,917,527

Total Claims

650K

Beneficiaries

42K

15.4 claims/patient

Avg Cost/Claim

$245

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

🔍 Analysis

Provider Overview

The Arc of Essex County, INC is a Respite Care provider based in Livingston, NJ. From the 2018–2024 period, this provider received $158.9M in Medicaid payments across 650K claims.

Important Context

  • ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.

Why This Matters

This provider received $158.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,864 Medicaid beneficiaries for a full year at average per-enrollee costs.

33% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$20.0M
+16%
2019
$23.3M
-18%
2020
$19.1M
+2%
2021
$19.4M
+21%
2022
$23.4M
+16%
2023
$27.2M
-2%
2024
$26.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 8 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 78% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$123.5M

316K claims · 77.7%

Your Cost: $390.74/claim|Median: $321.53
1.2× median
T2021Normal range

Day habilitation, waiver; per 15 min

$31.9M

270K claims · 20.1%

Your Cost: $118.27/claim|Median: $150.51
0.8× median
T1005Top 25%

Respite care services, per 15 minutes

$1.8M

16K claims · 1.2%

Your Cost: $113.03/claim|Median: $71.40
1.6× median
H2021Normal range

Community-based wrap-around services, per 15 min

$702K

13K claims · 0.4%

Your Cost: $56.05/claim|Median: $169.11
0.3× median
T2036Normal range

Therapeutic camping, waiver, per diem

$475K

4K claims · 0.3%

Your Cost: $135.75/claim|Median: $413.93
0.3× median
A0090Normal range

Non-emergency transport, per mile

$233K

25K claims · 0.1%

Your Cost: $9.27/claim|Median: $10.45
0.9× median
H2015Normal range

Comprehensive community support services, per 15 min

$169K

5K claims · 0.1%

Your Cost: $37.25/claim|Median: $96.24
0.4× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$29K

2K claims · 0.0%

Your Cost: $16.86/claim|Median: $74.63
0.2× median