Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 1 procedure codes: G0406 at 23.6× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $142.31 per claim for G0406 — 23.6× the national median of $6.02.
Billing in the top 1% nationally for 1 procedure code: G0406.
This is a statistical summary, not an accusation. See our methodology.
Compared to Home Health Peers
Total spending distribution among 322 providers in this specialty
This provider's total spending of $686.3M is at the 90th percentile among 322 Home Health providers.
Above 90th percentile for this specialty — higher spending than 289 of 322 peers
Total Paid
$686.3M
$686,260,064
Total Claims
3.7M
Beneficiaries
178K
20.6 claims/patient
Avg Cost/Claim
$187
#73 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Americare Inc. is a Home Health provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $686.3M in Medicaid payments across 3.7M claims.
Why This Matters
This provider received $686.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 85,782 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 10 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 84% of total spending.
$575.8M
3.3M claims
$173.06
$82.47
Personal care services, per 15 min
$575.8M
3.3M claims · 83.9%
$109.3M
328K claims
$333.02
$296.27
Personal care services, per diem
$109.3M
328K claims · 15.9%
$394K
2K claims
$205.03
$259.38
Supported employment, waiver, per diem
$394K
2K claims · 0.1%
$335K
4K claims
$85.42
$90.35
Physical therapy, in the home, per diem
$335K
4K claims · 0.0%
$260K
2K claims
$111.85
$85.62
Nursing care, in the home, by RN, per diem
$260K
2K claims · 0.0%
$130K
1K claims · 0.0%
$85K
804 claims · 0.0%
$6K
39 claims · 0.0%
$6K
85 claims
$65.06
$124.86
Nursing care, in the home, by RN, per 15 minutes
$6K
85 claims · 0.0%
$4K
44 claims
$88.64
$47.89
Physical therapy evaluation, low complexity
$4K
44 claims · 0.0%
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