Human Care Services for Families and Children INC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $469.67 per claim for H2015 (Comprehensive community support services, per 15 min), which is 4.9× the national median of $96.24.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $977K (2021) to $89.7M (2022) — a 9080% swing with $88.7M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: H2015 at 4.9× median, H2014 at 3.8× median.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 9080% from 2021 to 2022.
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.
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
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 $469.67 per claim for H2015 (Comprehensive community support services, per 15 min) — 4.9× the national median of $96.24.
Bills $315.53 per claim for H2014 (Skills training & development, per 15 min) — 3.8× the national median of $83.88.
Billing above the 90th percentile for 2 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities Peers
Total spending distribution among 19 providers in this specialty
This provider's total spending of $203.8M is at the 75th percentile among 19 Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities providers.
Total Paid
$203.8M
$203,820,196
Total Claims
612K
Beneficiaries
44K
13.8 claims/patient
Avg Cost/Claim
$333
#442 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Human Care Services for Families and Children INC is a Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $203.8M in Medicaid payments across 612K claims.
Why This Matters
This provider received $203.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,477 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 4 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 48% of total spending.
$98.5M
210K claims
$469.67
$96.24
Comprehensive community support services, per 15 min
$98.5M
210K claims · 48.3%
$50.7M
161K claims
$315.53
$83.88
Skills training & development, per 15 min
$50.7M
161K claims · 24.9%
Unskilled respite care, per 15 min
$49.7M
215K claims · 24.4%
$4.9M
26K claims
$185.71
$88.27
Habilitation, prevocational, waiver, per diem
$4.9M
26K claims · 2.4%
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