Is THE PRINCECARE GROUP flagged for Medicaid fraud?

THE PRINCECARE GROUP (NPI: 1831316595) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does THE PRINCECARE GROUP bill Medicaid?

THE PRINCECARE GROUP received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities provider. Located in LOUISVILLE, KY.

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THE PRINCECARE GROUP

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities·LOUISVILLE, KY·NPI: 1831316595Share

Compared to Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities Peers

Total spending distribution among 50 providers in this specialty

P25MedianP75P90

This provider's total spending of $18.9M is at the below 25th percentile among 50 Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$18.9M

$18,934,714

Total Claims

307K

Beneficiaries

63K

4.9 claims/patient

Avg Cost/Claim

$62

Monthly Spending Trend

Yearly Spending

2018

$2.3M

+10%

2019

$2.6M

-46%

2020

$1.4M

+58%

2021

$2.2M

+48%

2022

$3.2M

+16%

2023

$3.8M

-10%

2024

$3.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (S5100 (Day care services, adult, per half day)) accounts for 31% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

S5100Day care services, adult, per half daySee all providers →

$5.8M

74K claims

$78.55

$67.58

1.2×

Normal range

S5100Normal range

Day care services, adult, per half day

$5.8M

74K claims · 30.5%

Your Cost: $78.55/claim|Median: $67.58

1.2× median

97530Therapeutic activities, each 15 minSee all providers →

$3.6M

58K claims

$62.85

$33.11

1.9×

Top 25%

97530Top 25%

Therapeutic activities, each 15 min

$3.6M

58K claims · 19.1%

Your Cost: $62.85/claim|Median: $33.11

1.9× median

92507Speech/hearing/language treatmentSee all providers →

$3.1M

72K claims

$42.93

$49.45

0.9×

Normal range

92507Normal range

Speech/hearing/language treatment

$3.1M

72K claims · 16.4%

Your Cost: $42.93/claim|Median: $49.45

0.9× median

H0004Behavioral health counseling & therapy, per 15 minSee all providers →

$2.7M

16K claims

$167.07

$74.63

2.2×

Top 10%

H0004Top 10%

Behavioral health counseling & therapy, per 15 min

$2.7M

16K claims · 14.2%

Your Cost: $167.07/claim|Median: $74.63

2.2× median

92609 See all providers →

$1.6M

29K claims

$55.93

$59.78

0.9×

Normal range

92609Normal range

$1.6M

29K claims · 8.6%

Your Cost: $55.93/claim|Median: $59.78

0.9× median

97535Self-care/home management training, per 15 minutesSee all providers →

$447K

9,221 claims

$48.46

$18.18

2.7×

Top 25%

97535Top 25%

Self-care/home management training, per 15 minutes

$447K

9,221 claims · 2.4%

Your Cost: $48.46/claim|Median: $18.18

2.7× median

97533 See all providers →

$419K

8,070 claims

$51.89

$48.71

1.1×

Normal range

97533Normal range

$419K

8,070 claims · 2.2%

Your Cost: $51.89/claim|Median: $48.71

1.1× median

92526Treatment of swallowing dysfunction and/or oral functionSee all providers →

$382K

8,372 claims

$45.64

$49.74

0.9×

Normal range

92526Normal range

Treatment of swallowing dysfunction and/or oral function

$382K

8,372 claims · 2.0%

Your Cost: $45.64/claim|Median: $49.74

0.9× median

97110Therapeutic exercises, each 15 minSee all providers →

$374K

11K claims

$34.66

$24.49

1.4×

Normal range

97110Normal range

Therapeutic exercises, each 15 min

$374K

11K claims · 2.0%

Your Cost: $34.66/claim|Median: $24.49

1.4× median

97116Gait trainingSee all providers →

$175K

7,042 claims

$24.89

$12.48

2.0×

Top 25%

97116Top 25%

Gait training

$175K

7,042 claims · 0.9%

Your Cost: $24.89/claim|Median: $12.48

2.0× median

97112Therapeutic procedure, neuromuscular reeducation, per 15 minutesSee all providers →

$167K

5,350 claims

$31.26

$20.04

1.6×

Top 25%

97112Top 25%

Therapeutic procedure, neuromuscular reeducation, per 15 minutes

$167K

5,350 claims · 0.9%

Your Cost: $31.26/claim|Median: $20.04

1.6× median

92508Treatment of speech/language disorder, group, 2+ patientsSee all providers →

$108K

8,411 claims

$12.84

$13.22

1.0×

Normal range

92508Normal range

Treatment of speech/language disorder, group, 2+ patients

$108K

8,411 claims · 0.6%

Your Cost: $12.84/claim|Median: $13.22

1.0× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$37K

786 claims

$46.47

$150.51

0.3×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$37K

786 claims · 0.2%

Your Cost: $46.47/claim|Median: $150.51

0.3× median

92523Evaluation of speech sound production with language comprehensionSee all providers →

$2K

12 claims

$131.80

$110.87

1.2×

Normal range

92523Normal range

Evaluation of speech sound production with language comprehension

$2K

12 claims · 0.0%

Your Cost: $131.80/claim|Median: $110.87

1.2× median

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Cumberland River Behavioral Health INC

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$349.2M

Addiction Recovery Care LLC

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$309.0M

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