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

Consumer Direct District of Columbia

Home Health·Missoula, MT·NPI: 1619334323Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $392.7M is at the 75th percentile among 322 Home Health providers.

Active Billing Period:2018-012023-06(66 months)

Total Paid

$392.7M

$392,677,097

Total Claims

1.9M

Beneficiaries

71K

27.1 claims/patient

Avg Cost/Claim

$205

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

🔍 Analysis

Provider Overview

Consumer Direct District of Columbia is a Home Health provider based in Missoula, MT. From the 2018–2024 period, this provider received $392.7M in Medicaid payments across 1.9M claims.

Important Context

  • ℹ️This provider is a known fiscal management organization for self-directed care programs. They manage billing on behalf of thousands of individual caregivers, so aggregate billing is high by design. However, the self-directed care category has been identified as fraud-prone by regulators.

Why This Matters

This provider received $392.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 49,084 Medicaid beneficiaries for a full year at average per-enrollee costs.

59% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$42.5M
+36%
2019
$57.9M
+32%
2020
$76.7M
+19%
2021
$90.9M
+18%
2022
$107.3M
-84%
2023
$17.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 8 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 100% of total spending.

T1019Top 25%

Personal care services, per 15 min

$392.6M

1.9M claims · 100.0%

Your Cost: $205.71/claim|Median: $82.47
2.5× median
G9001Top 25%

$60K

374 claims · 0.0%

Your Cost: $159.22/claim|Median: $53.98
3.0× median

$0

534 claims · 0.0%

$0

54 claims · 0.0%

$0

32 claims · 0.0%

$0

12 claims · 0.0%

$0

28 claims · 0.0%

T2040Normal range

Financial management, self-directed; per month

$0

8K claims · 0.0%

Your Cost: $0.00/claim|Median: $108.97