Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Preferred Home Health Care & Nursing Services Inc.

Home Health·Mount Laurel, NJ·NPI: 1043279011SharePrint Report

Red Flags Explained

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.

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Change PointBilling shifted 0.1x in 2023-01

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $428.91 per claim for T1003 (LPN/LVN services, per 15 minutes) — 17.7× the national median of $24.24.

Bills $464.65 per claim for T1002 (RN services, per 15 minutes) — 12.4× the national median of $37.42.

Bills $447.40 per claim for S9123 (Nursing care, in the home, by RN, per 15 minutes) — 3.6× the national median of $124.86.

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

P25MedianP75P90

This provider's total spending of $224.6M is at the 50th percentile among 322 Home Health providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$224.6M

$224,601,484

Total Claims

577K

Beneficiaries

38K

15.1 claims/patient

Avg Cost/Claim

$389

#376 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Preferred Home Health Care & Nursing Services Inc. is a Home Health provider based in Mount Laurel, NJ. From the 2018–2024 period, this provider received $224.6M in Medicaid payments across 577K claims.

Why This Matters

This provider received $224.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 28,075 Medicaid beneficiaries for a full year at average per-enrollee costs.

100% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$40.6M
+1%
2019
$40.8M
+6%
2020
$43.4M
+14%
2021
$49.6M
-8%
2022
$45.7M
-90%
2023
$4.4M
-97%
2024
$144K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 13 distinct procedure codes. The top code (T1003 (LPN/LVN services, per 15 minutes)) accounts for 50% of total spending.

T1003Top 25%

LPN/LVN services, per 15 minutes

$112.4M

262K claims · 50.0%

Your Cost: $428.91/claim|Median: $24.24
17.7× median
S9124Normal range

Nursing care, in the home; per hour

$48.6M

113K claims · 21.6%

Your Cost: $430.41/claim|Median: $400.25
1.1× median
T1002Top 5%

RN services, per 15 minutes

$41.9M

90K claims · 18.7%

Your Cost: $464.65/claim|Median: $37.42
12.4× median
S9123Top 25%

Nursing care, in the home, by RN, per 15 minutes

$14.5M

32K claims · 6.4%

Your Cost: $447.40/claim|Median: $124.86
3.6× median
T1019Normal range

Personal care services, per 15 min

$6.1M

72K claims · 2.7%

Your Cost: $84.09/claim|Median: $82.47
1.0× median
E0603Normal range

Breast pump, electric, any type

$668K

4K claims · 0.3%

Your Cost: $149.70/claim|Median: $131.70
1.1× median
T1000Normal range

Private duty/independent nursing service(s)

$487K

1K claims · 0.2%

Your Cost: $368.90/claim|Median: $402.76
0.9× median
K1005Normal range

$36K

1K claims · 0.0%

Your Cost: $33.32/claim|Median: $37.63
0.9× median
A4287Top 25%

$22K

381 claims · 0.0%

Your Cost: $58.80/claim|Median: $38.21
1.5× median
A4285Normal range

$674

88 claims · 0.0%

Your Cost: $7.65/claim|Median: $5.69
1.4× median
A4284Normal range

$555

89 claims · 0.0%

Your Cost: $6.24/claim|Median: $9.85
0.6× median
A4281Normal range

$484

89 claims · 0.0%

Your Cost: $5.44/claim|Median: $6.31
0.9× median
A4283Normal range

$59

18 claims · 0.0%

Your Cost: $3.30/claim|Median: $3.61
0.9× median