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Acumen of North Carolina, LLC

Case Management·Charlotte, NC·NPI: 1578971214Share

Compared to Case Management Peers

Total spending distribution among 137 providers in this specialty

P25MedianP75P90

This provider's total spending of $134.3M is at the 50th percentile among 137 Case Management providers.

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

Total Paid

$134.3M

$134,277,839

Total Claims

1.5M

Beneficiaries

114K

13.0 claims/patient

Avg Cost/Claim

$90

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

🔍 Analysis

Provider Overview

Acumen of North Carolina, LLC is a Case Management provider based in Charlotte, NC. From the 2018–2024 period, this provider received $134.3M in Medicaid payments across 1.5M 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 $134.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,784 Medicaid beneficiaries for a full year at average per-enrollee costs.

150% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$11.5M
+39%
2019
$16.0M
+27%
2020
$20.2M
-5%
2021
$19.3M
-8%
2022
$17.8M
+17%
2023
$20.8M
+38%
2024
$28.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 6 distinct procedure codes. The top code (S5135 (Companion care, adult, per diem)) accounts for 56% of total spending.

S5135Normal range

Companion care, adult, per diem

$75.3M

867K claims · 56.1%

Your Cost: $86.80/claim|Median: $52.25
1.7× median
T1019Normal range

Personal care services, per 15 min

$23.2M

196K claims · 17.3%

Your Cost: $118.08/claim|Median: $82.47
1.4× median
T2027Normal range

Specialized transportation, waiver, per trip, extra

$18.5M

207K claims · 13.8%

Your Cost: $89.10/claim|Median: $88.93
1.0× median
S5150Normal range

Unskilled respite care, per 15 min

$8.1M

113K claims · 6.1%

Your Cost: $72.02/claim|Median: $84.46
0.8× median
T2040Normal range

Financial management, self-directed; per month

$4.6M

56K claims · 3.4%

Your Cost: $83.01/claim|Median: $108.97
0.8× median
T1004Top 25%

Services of a qualified nursing aide, per 15 minutes

$4.6M

49K claims · 3.4%

Your Cost: $93.66/claim|Median: $50.30
1.9× median