Sierra Regional Center
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $2,343.49 per claim for T2017 (Habilitation, residential, waiver; 15 min), which is 17.1× the national median of $137.32.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: T2017 at 17.1× median, T2003 at 4.0× 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
▼
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.
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 $2,343.49 per claim for T2017 (Habilitation, residential, waiver; 15 min) — 17.1× the national median of $137.32.
Bills $87.86 per claim for T2003 (Non-emergency transport; encounter/trip) — 4.0× the national median of $21.70.
Bills $152.77 per claim for T1001 (Nursing assessment/evaluation, per visit) — 3.1× the national median of $49.05.
Billing above the 90th percentile for 3 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Respite Care Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $225.2M is at the 75th percentile among 8 Respite Care providers.
Total Paid
$225.2M
$225,241,767
Total Claims
488K
Beneficiaries
85K
5.7 claims/patient
Avg Cost/Claim
$462
#374 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Sierra Regional Center is a Respite Care provider based in Sparks, NV. From the 2018–2024 period, this provider received $225.2M in Medicaid payments across 488K claims.
Why This Matters
This provider received $225.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 28,155 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 11 distinct procedure codes. The top code (T2017 (Habilitation, residential, waiver; 15 min)) accounts for 77% of total spending.
$173.8M
74K claims
$2,343.49
$137.32
Habilitation, residential, waiver; 15 min
$173.8M
74K claims · 77.2%
$25.3M
77K claims
$328.22
$331.94
Habilitation, residential, waiver; per diem
$25.3M
77K claims · 11.2%
$10.2M
112K claims
$91.13
$87.34
Day habilitation, waiver; per diem
$10.2M
112K claims · 4.5%
$8.5M
129K claims
$65.31
$74.75
Habilitation, prevocational, waiver, per hour
$8.5M
129K claims · 3.8%
$2.9M
42K claims
$69.18
$124.39
Waiver services, NOS; per 15 min
$2.9M
42K claims · 1.3%
$2.5M
28K claims
$87.86
$21.70
Non-emergency transport; encounter/trip
$2.5M
28K claims · 1.1%
$973K
9K claims
$114.05
$150.51
Day habilitation, waiver; per 15 min
$973K
9K claims · 0.4%
$759K
8K claims · 0.3%
$175K
5K claims
$32.91
$259.38
Supported employment, waiver, per diem
$175K
5K claims · 0.1%
$148K
3K claims
$49.61
$20.02
Health behavior intervention, individual
$148K
3K claims · 0.1%
$4K
25 claims
$152.77
$49.05
Nursing assessment/evaluation, per visit
$4K
25 claims · 0.0%
Other Top Providers in Nevada
View all →Similar Providers
Other top providers in Respite Care