Hamaspik of Kings County Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $445.32 per claim for H2015 (Comprehensive community support services, per 15 min), which is 4.6× the national median of $96.24.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $9.6M (2020) to $48.7M (2021) — a 410% swing with $39.2M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 11 procedure codes: H2015 at 4.6× median, 90834 at 2.3× 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:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
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.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $445.32 per claim for H2015 (Comprehensive community support services, per 15 min) — 4.6× the national median of $96.24.
Bills $79.60 per claim for 97110 (Therapeutic exercises, each 15 min) — 3.3× the national median of $24.49.
Bills $233.06 per claim for 90847 (Family psychotherapy with patient, 50 min) — 3.0× the national median of $77.33.
Billing above the 90th percentile for 11 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Case Management Peers
Total spending distribution among 137 providers in this specialty
This provider's total spending of $295.4M is at the 75th percentile among 137 Case Management providers.
Total Paid
$295.4M
$295,371,494
Total Claims
1.1M
Beneficiaries
78K
14.6 claims/patient
Avg Cost/Claim
$259
#252 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Hamaspik of Kings County Inc. is a Case Management provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $295.4M in Medicaid payments across 1.1M 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.
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $295.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 36,921 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 23 distinct procedure codes. The top code (H2014 (Skills training & development, per 15 min)) accounts for 41% of total spending.
$120.5M
552K claims
$218.46
$83.88
Skills training & development, per 15 min
$120.5M
552K claims · 40.8%
Unskilled respite care, per 15 min
$89.1M
357K claims · 30.2%
$78.4M
176K claims
$445.32
$96.24
Comprehensive community support services, per 15 min
$78.4M
176K claims · 26.5%
$3.8M
18K claims
$209.03
$88.27
Habilitation, prevocational, waiver, per diem
$3.8M
18K claims · 1.3%
Psychotherapy, 45 minutes
$1.7M
12K claims · 0.6%
Psychiatric diagnostic evaluation
$282K
2K claims · 0.1%
Speech/hearing/language treatment
$280K
4K claims · 0.1%
Therapeutic exercises, each 15 min
$275K
3K claims · 0.1%
$221K
1K claims
$174.22
$74.63
Behavioral health counseling & therapy, per 15 min
$221K
1K claims · 0.1%
$218K
8K claims
$28.75
$69.56
Targeted case management, per 15 min
$218K
8K claims · 0.1%
$147K
1K claims
$130.15
$76.05
Community psychiatric supportive treatment, per 15 min
$147K
1K claims · 0.0%
$147K
1K claims
$115.28
$91.63
Psychosocial rehabilitation services, per 15 min
$147K
1K claims · 0.0%
$99K
892 claims
$111.20
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$99K
892 claims · 0.0%
$73K
5K claims · 0.0%
$55K
501 claims
$109.42
$76.61
Family psychotherapy without patient, 50 min
$55K
501 claims · 0.0%
$38K
161 claims
$233.06
$77.33
Family psychotherapy with patient, 50 min
$38K
161 claims · 0.0%
$36K
135 claims
$267.90
$249.18
Unskilled respite care, per diem
$36K
135 claims · 0.0%
$31K
389 claims
$79.69
$20.04
Therapeutic procedure, neuromuscular reeducation, per 15 minutes
$31K
389 claims · 0.0%
Group psychotherapy
$15K
170 claims · 0.0%
$13K
170 claims
$75.31
$84.12
Therapeutic behavioral services, per 15 min
$13K
170 claims · 0.0%
Therapeutic activities, each 15 min
$10K
120 claims · 0.0%
Developmental test administration
$8K
23 claims · 0.0%
Psychotherapy, 30 minutes
$7K
63 claims · 0.0%
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