National Mentor Healthcare Network
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $4,124.24 per claim for T2023 (Community transition, waiver; per service), which is 13.7× the national median of $300.13.
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.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about 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 $115.0M is at the 50th percentile among 19 Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities providers.
Total Paid
$115.0M
$114,960,150
Total Claims
293K
Beneficiaries
42K
7.0 claims/patient
Avg Cost/Claim
$393
🔍 Analysis
Provider Overview
National Mentor Healthcare Network is a Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities provider based in Jacksonville, FL. From the 2018–2024 period, this provider received $115.0M in Medicaid payments across 293K claims.
Why This Matters
This provider received $115.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 14,370 Medicaid beneficiaries for a full year at average per-enrollee costs.
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