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Central Boston Elder Services, Inc.

Case Management·Roxbury, MA·NPI: 1629282272Share

Compared to Case Management Peers

Total spending distribution among 137 providers in this specialty

P25MedianP75P90

This provider's total spending of $186.7M is at the 50th percentile among 137 Case Management providers.

Active Billing Period:2018-01→2024-10(82 months)

Total Paid

$186.7M

$186,664,286

Total Claims

1.9M

Beneficiaries

410K

4.5 claims/patient

Avg Cost/Claim

$101

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

🔍 Analysis

Provider Overview

Central Boston Elder Services, Inc. is a Case Management provider based in Roxbury, MA. From the 2018–2024 period, this provider received $186.7M in Medicaid payments across 1.9M 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 $186.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 23,333 Medicaid beneficiaries for a full year at average per-enrollee costs.

↓ 30% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$20.8M
+32%
2019
$27.4M
+9%
2020
$30.0M
+9%
2021
$32.8M
+5%
2022
$34.6M
-23%
2023
$26.5M
-45%
2024
$14.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (S5130 (Homemaker service, NOS; per 15 min)) accounts for 33% of total spending.

S5130Top 25%

Homemaker service, NOS; per 15 min

$60.9M

549K claims · 32.6%

Your Cost: $110.98/claim|Median: $48.76
2.3× median
T1019Top 25%

Personal care services, per 15 min

$57.8M

286K claims · 31.0%

Your Cost: $201.93/claim|Median: $82.47
2.5× median
S5170Normal range

Homemaker service, NOS, per diem

$20.3M

702K claims · 10.9%

Your Cost: $28.88/claim|Median: $19.89
1.4× median
G0156Top 5%

Home health aide services, per visit

$15.8M

22K claims · 8.5%

Your Cost: $715.63/claim|Median: $39.42
18.1× median
S5135Top 25%

Companion care, adult, per diem

$14.3M

94K claims · 7.6%

Your Cost: $151.55/claim|Median: $52.25
2.9× median
S5102Top 10%

Day care services, adult; per 15 min

$4.5M

20K claims · 2.4%

Your Cost: $219.94/claim|Median: $81.10
2.7× median
S5125Top 10%

Attendant care services, per 15 min

$2.9M

7K claims · 1.5%

Your Cost: $423.87/claim|Median: $82.34
5.2× median
T2003Top 10%

Non-emergency transport; encounter/trip

$2.1M

18K claims · 1.1%

Your Cost: $120.32/claim|Median: $21.70
5.5× median
S5120Top 10%

Chore services, per 15 min

$1.9M

8K claims · 1.0%

Your Cost: $227.52/claim|Median: $70.19
3.2× median
S5175Normal range

Laundry service, per occasion

$1.6M

53K claims · 0.9%

Your Cost: $30.56/claim|Median: $30.40
1.0× median
S5161Normal range

Emergency response system, per month

$1.5M

58K claims · 0.8%

Your Cost: $24.93/claim|Median: $29.97
0.8× median
S5165Normal range

Home modifications, per service

$644K

3K claims · 0.3%

Your Cost: $222.27/claim|Median: $2,196.32
0.1× median
G9001Normal range

$624K

9K claims · 0.3%

Your Cost: $71.27/claim|Median: $53.98
1.3× median
G0299Top 5%

Skilled nursing services, home health, per visit, RN

$441K

2K claims · 0.2%

Your Cost: $273.27/claim|Median: $51.67
5.3× median
T1020Normal range

Personal care services, per diem

$403K

8K claims · 0.2%

Your Cost: $52.88/claim|Median: $296.27
0.2× median
T2022Normal range

Case management, per month

$272K

5K claims · 0.1%

Your Cost: $53.11/claim|Median: $202.77
0.3× median
T1016Top 25%

Case management, each 15 min

$229K

1K claims · 0.1%

Your Cost: $162.87/claim|Median: $49.62
3.3× median
S5101Normal range

Day care services, adult, per half day

$152K

2K claims · 0.1%

Your Cost: $73.43/claim|Median: $66.43
1.1× median
H0043Top 10%

Supported housing, per diem

$103K

105 claims · 0.1%

Your Cost: $982.32/claim|Median: $164.87
6.0× median
99437Top 25%

$69K

1K claims · 0.0%

Your Cost: $62.66/claim|Median: $8.33
7.5× median
T2024Normal range

Supported employment, waiver, per diem

$67K

418 claims · 0.0%

Your Cost: $160.00/claim|Median: $259.38
0.6× median
96160Top 5%

Patient-focused health risk assessment

$41K

1K claims · 0.0%

Your Cost: $34.37/claim|Median: $2.10
16.4× median
H0046Normal range

Mental health services, not otherwise specified

$38K

902 claims · 0.0%

Your Cost: $42.66/claim|Median: $85.02
0.5× median
S5121Normal range

Attendant care services, in-home, per 15 min

$29K

909 claims · 0.0%

Your Cost: $32.04/claim|Median: $111.06
0.3× median
S5140Top 10%

Foster care, adult; per diem

$29K

13 claims · 0.0%

Your Cost: $2,197.27/claim|Median: $252.32
8.7× median
S0250Top 25%

$25K

177 claims · 0.0%

Your Cost: $140.00/claim|Median: $66.58
2.1× median
T1023Normal range

Screening to determine appropriateness of consideration for program

$22K

185 claims · 0.0%

Your Cost: $116.93/claim|Median: $106.70
1.1× median
99339Top 25%

$7K

130 claims · 0.0%

Your Cost: $50.89/claim|Median: $37.37
1.4× median
G9002Normal range

Coordinated care fee, maintenance period

$3K

2K claims · 0.0%

Your Cost: $2.07/claim|Median: $108.80
0.0× median
T1013Top 5%

Sign language or oral interpretive services, per 15 minutes

$2K

14 claims · 0.0%

Your Cost: $163.93/claim|Median: $17.67
9.3× median

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