Americare Certified Special Services Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $245.64 per claim for G0156 (Home health aide services, per visit), which is 6.2× the national median of $39.42.
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $3.3M (2023) to $61.4M (2024) — a 1756% swing with $58.1M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1756% from 2023 to 2024.
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.
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.
Risk Assessment
Bills $245.64 per claim for G0156 (Home health aide services, per visit) — 6.2× the national median of $39.42.
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 $60.1M is at the below 25th percentile among 322 Home Health providers.
Total Paid
$60.1M
$60,110,322
Total Claims
0
Beneficiaries
0
Avg Cost/Claim
$0
🔍 Analysis
Provider Overview
Americare Certified Special Services Inc. is a Home Health provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $0 in Medicaid payments across 0 claims.
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 10 distinct procedure codes. The top code (G0156 (Home health aide services, per visit)) accounts for 100% of total spending.
$60.1M
245K claims
$245.64
$39.42
Home health aide services, per visit
$60.1M
245K claims · 100.0%
$7.9M
88K claims
$89.35
$85.62
Nursing care, in the home, by RN, per diem
$7.9M
88K claims · 13.1%
$3.5M
26K claims
$132.19
$124.86
Nursing care, in the home, by RN, per 15 minutes
$3.5M
26K claims · 5.8%
$3.4M
52K claims
$64.15
$90.35
Physical therapy, in the home, per diem
$3.4M
52K claims · 5.6%
$1.4M
12K claims
$118.63
$116.67
Home health aide or certified nurse, per hour
$1.4M
12K claims · 2.3%
OT, in the home, per diem
$1.1M
13K claims · 1.8%
$741K
8,294 claims
$89.31
$49.05
Nursing assessment/evaluation, per visit
$741K
8,294 claims · 1.2%
$663K
8,668 claims
$76.54
$80.56
Nursing care, in the home, by LPN, per diem
$663K
8,668 claims · 1.1%
$241K
2,277 claims
$106.02
$72.77
Speech therapy, in the home, per diem
$241K
2,277 claims · 0.4%
$170K
1,491 claims
$113.74
$68.93
Occupational therapy services, home health, per visit
$170K
1,491 claims · 0.3%
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