Is COVENANT CASE MANAGEMENT SERVICES, LLC flagged for Medicaid fraud?

COVENANT CASE MANAGEMENT SERVICES, LLC (NPI: 1982921227) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does COVENANT CASE MANAGEMENT SERVICES, LLC bill Medicaid?

COVENANT CASE MANAGEMENT SERVICES, LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in MATTHEWS, NC.

What is NPI 1982921227?

NPI 1982921227 is the National Provider Identifier for COVENANT CASE MANAGEMENT SERVICES, LLC. They are a Community/Behavioral Health provider based in MATTHEWS, NC. This NPI is registered with the CMS NPI Registry.

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COVENANT CASE MANAGEMENT SERVICES, LLC

Community/Behavioral Health·MATTHEWS, NC·NPI: 1982921227Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $72.7M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$72.7M

$72,730,293

Total Claims

444K

Beneficiaries

44K

10.1 claims/patient

Avg Cost/Claim

$164

Monthly Spending Trend

Yearly Spending

2018

$1.1M

+254%

2019

$3.8M

+61%

2020

$6.2M

+49%

2021

$9.2M

+33%

2022

$12.3M

+87%

2023

$23.0M

-26%

2024

$17.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (T2012 (Habilitation, educational; per 15 min)) accounts for 27% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2012Habilitation, educational; per 15 minSee all providers →

$19.8M

95K claims

$207.64

$177.54

1.2×

Top 25%

T2012Top 25%

Habilitation, educational; per 15 min

$19.8M

95K claims · 27.2%

Your Cost: $207.64/claim|Median: $177.54

1.2× median

T2013Habilitation, residential, waiver, per hourSee all providers →

$17.2M

101K claims

$171.12

$158.23

1.1×

Normal range

T2013Normal range

Habilitation, residential, waiver, per hour

$17.2M

101K claims · 23.7%

Your Cost: $171.12/claim|Median: $158.23

1.1× median

H2015Comprehensive community support services, per 15 minSee all providers →

$8.2M

72K claims

$114.01

$96.24

1.2×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$8.2M

72K claims · 11.3%

Your Cost: $114.01/claim|Median: $96.24

1.2× median

H2016Comprehensive community support services, per 15 minSee all providers →

$7.3M

38K claims

$193.03

$321.53

0.6×

Normal range

H2016Normal range

Comprehensive community support services, per 15 min

$7.3M

38K claims · 10.0%

Your Cost: $193.03/claim|Median: $321.53

0.6× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$5.6M

34K claims

$161.46

$150.51

1.1×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$5.6M

34K claims · 7.6%

Your Cost: $161.46/claim|Median: $150.51

1.1× median

T2025Waiver services, NOS; per 15 minSee all providers →

$4.2M

15K claims

$273.75

$124.39

2.2×

Normal range

T2025Normal range

Waiver services, NOS; per 15 min

$4.2M

15K claims · 5.8%

Your Cost: $273.75/claim|Median: $124.39

2.2× median

S5150Unskilled respite care, per 15 minSee all providers →

$3.7M

41K claims

$90.87

$84.46

1.1×

Normal range

S5150Normal range

Unskilled respite care, per 15 min

$3.7M

41K claims · 5.1%

Your Cost: $90.87/claim|Median: $84.46

1.1× median

H2025Ongoing support to maintain employment, per 15 minSee all providers →

$2.6M

22K claims

$121.26

$100.49

1.2×

Normal range

H2025Normal range

Ongoing support to maintain employment, per 15 min

$2.6M

22K claims · 3.6%

Your Cost: $121.26/claim|Median: $100.49

1.2× median

T2041Supports brokerage, self-directed; per 15 minSee all providers →

$2.4M

15K claims

$159.65

$162.29

1.0×

Normal range

T2041Normal range

Supports brokerage, self-directed; per 15 min

$2.4M

15K claims · 3.3%

Your Cost: $159.65/claim|Median: $162.29

1.0× median

S5125Attendant care services, per 15 minSee all providers →

$872K

5,424 claims

$160.71

$82.34

2.0×

Top 25%

S5125Top 25%

Attendant care services, per 15 min

$872K

5,424 claims · 1.2%

Your Cost: $160.71/claim|Median: $82.34

2.0× median

99509Home visit, assistance w/ ADLsSee all providers →

$697K

4,421 claims

$157.62

$51.71

3.0×

Top 10%

99509Top 10%

Home visit, assistance w/ ADLs

$697K

4,421 claims · 1.0%

Your Cost: $157.62/claim|Median: $51.71

3.0× median

T1017Targeted case management, per 15 minSee all providers →

$159K

591 claims

$268.35

$69.56

3.9×

Top 10%

T1017Top 10%

Targeted case management, per 15 min

$159K

591 claims · 0.2%

Your Cost: $268.35/claim|Median: $69.56

3.9× median

T2013TF See all providers →

$26K

132 claims

$199.65

$168.77

1.2×

Top 10%

T2013TFTop 10%

$26K

132 claims · 0.0%

Your Cost: $199.65/claim|Median: $168.77

1.2× median

T1019Personal care services, per 15 minSee all providers →

$14K

108 claims

$130.34

$82.47

1.6×

Normal range

T1019Normal range

Personal care services, per 15 min

$14K

108 claims · 0.0%

Your Cost: $130.34/claim|Median: $82.47

1.6× median

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