Community Bridges
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: T2025 at 7.8× median, H2032 at 4.8× 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 $965.57 per claim for T2025 (Waiver services, NOS; per 15 min) — 7.8× the national median of $124.39.
Bills $524.65 per claim for H2032 (Activity therapy, per 15 minutes) — 4.8× the national median of $108.23.
Billing above the 90th percentile for 2 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 $265.5M is at the 75th percentile among 137 Case Management providers.
Total Paid
$265.5M
$265,469,407
Total Claims
970K
Beneficiaries
122K
8.0 claims/patient
Avg Cost/Claim
$274
#301 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Community Bridges is a Case Management provider based in Concord, NH. From the 2018–2024 period, this provider received $265.5M in Medicaid payments across 970K 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.
Why This Matters
This provider received $265.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 33,183 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 14 distinct procedure codes. The top code (T1020 (Personal care services, per diem)) accounts for 52% of total spending.
$137.0M
442K claims
$309.75
$296.27
Personal care services, per diem
$137.0M
442K claims · 51.6%
Waiver services, NOS; per 15 min
$54.1M
56K claims · 20.4%
$51.2M
320K claims
$160.23
$150.51
Day habilitation, waiver; per 15 min
$51.2M
320K claims · 19.3%
Case management, per month
$9.6M
43K claims · 3.6%
$4.1M
17K claims
$240.32
$119.08
Evaluation & treatment, integrated specialty team
$4.1M
17K claims · 1.5%
$3.3M
16K claims
$209.20
$300.13
Community transition, waiver; per service
$3.3M
16K claims · 1.3%
$2.3M
32K claims
$71.38
$96.24
Comprehensive community support services, per 15 min
$2.3M
32K claims · 0.9%
$1.6M
20K claims
$81.91
$71.40
Respite care services, per 15 minutes
$1.6M
20K claims · 0.6%
$1.5M
22K claims
$71.58
$103.94
Supported employment, per 15 min
$1.5M
22K claims · 0.6%
$509K
2K claims
$268.57
$215.80
Crisis intervention service, per 15 minutes
$509K
2K claims · 0.2%
$99K
1K claims
$79.82
$84.12
Therapeutic behavioral services, per 15 min
$99K
1K claims · 0.0%
Activity therapy, per 15 minutes
$69K
132 claims · 0.0%
Non-emergency transport; per trip
$9K
186 claims · 0.0%
$269
22 claims
$12.22
$83.88
Skills training & development, per 15 min
$269
22 claims · 0.0%
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