Caregivers Home Health TX INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 7 procedure codes: 97124 at 5.1× median, T2015 at 12.4× 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 $89.98 per claim for 97124 — 5.1× the national median of $17.78.
Bills $1,098.94 per claim for T2015 (Habilitation, prevocational, waiver, per diem) — 12.4× the national median of $88.27.
Bills $934.87 per claim for E1399 (Durable medical equipment, miscellaneous) — 9.0× the national median of $104.06.
Billing in the top 1% nationally for 1 procedure code: G0227.
This is a statistical summary, not an accusation. See our methodology.
Compared to Nursing Care Peers
Total spending distribution among 10 providers in this specialty
This provider's total spending of $477.7M is at the 99th percentile among 10 Nursing Care providers.
Above 99th percentile for this specialty — higher spending than 9 of 10 peers
Total Paid
$477.7M
$477,736,242
Total Claims
4.0M
Beneficiaries
441K
9.0 claims/patient
Avg Cost/Claim
$120
#130 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Caregivers Home Health TX INC is a Nursing Care provider based in Richardson, TX. From the 2018–2024 period, this provider received $477.7M in Medicaid payments across 4.0M claims.
Why This Matters
This provider received $477.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 59,717 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 30 distinct procedure codes. The top code (T2016 (Habilitation, residential, waiver; per diem)) accounts for 35% of total spending.
$167.6M
1.5M claims
$114.86
$331.94
Habilitation, residential, waiver; per diem
$167.6M
1.5M claims · 35.1%
$163.5M
898K claims
$182.12
$170.05
Specialized transportation, waiver, per trip
$163.5M
898K claims · 34.2%
Activity therapy, per 15 minutes
$38.4M
183K claims · 8.0%
$22.4M
249K claims · 4.7%
$11.5M
111K claims
$103.70
$187.28
Respite care, in the home, per diem
$11.5M
111K claims · 2.4%
$10.9M
54K claims · 2.3%
$9.9M
118K claims
$84.00
$85.09
Activity therapy (group), per session
$9.9M
118K claims · 2.1%
$9.0M
8K claims
$1,098.94
$88.27
Habilitation, prevocational, waiver, per diem
$9.0M
8K claims · 1.9%
$7.7M
553K claims · 1.6%
$5.0M
64K claims
$78.41
$82.34
Attendant care services, per 15 min
$5.0M
64K claims · 1.1%
$4.9M
60K claims · 1.0%
$4.4M
36K claims · 0.9%
$3.5M
44K claims
$80.09
$82.47
Personal care services, per 15 min
$3.5M
44K claims · 0.7%
$2.7M
29K claims
$92.68
$137.32
Habilitation, residential, waiver; 15 min
$2.7M
29K claims · 0.6%
$2.2M
27K claims
$83.11
$108.97
Financial management, self-directed; per month
$2.2M
27K claims · 0.5%
$2.1M
2K claims
$934.87
$104.06
Durable medical equipment, miscellaneous
$2.1M
2K claims · 0.4%
$1.8M
3K claims
$689.98
$37.60
Unspecified adjunctive procedure, by report
$1.8M
3K claims · 0.4%
$1.8M
21K claims · 0.4%
$1.7M
19K claims
$93.86
$71.40
Respite care services, per 15 minutes
$1.7M
19K claims · 0.4%
$1.7M
11K claims
$155.18
$84.12
Therapeutic behavioral services, per 15 min
$1.7M
11K claims · 0.4%
RN services, per 15 minutes
$1.7M
9K claims · 0.3%
Unskilled respite care, per diem
$1.3M
1K claims · 0.3%
$601K
7K claims
$84.66
$96.24
Comprehensive community support services, per 15 min
$601K
7K claims · 0.1%
$396K
5K claims
$86.86
$101.43
Services of SLP in home health, per 15 min
$396K
5K claims · 0.1%
$377K
2K claims · 0.1%
$253K
3K claims
$89.30
$67.94
Physical therapy services, home health, per visit
$253K
3K claims · 0.1%
$144K
134 claims · 0.0%
$47K
2K claims
$30.05
$29.97
Emergency response system, per month
$47K
2K claims · 0.0%
$47K
4K claims
$13.18
$259.38
Supported employment, waiver, per diem
$47K
4K claims · 0.0%
$10K
84 claims · 0.0%
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