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

Wall Residences LLC

Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities·Floyd, VA·NPI: 1063436723SharePrint 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.

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 $6,295.99 per claim for T2033 (Residential care, NOS; per diem) — 6.0× the national median of $1,051.57.

Bills $8,178.90 per claim for H2022 (Community-based wrap-around services, per diem) — 24.3× the national median of $336.31.

Bills $1,118.99 per claim for T2021 (Day habilitation, waiver; per 15 min) — 7.4× the national median of $150.51.

Billing in the top 1% nationally for 4 procedure codes: 97127, 97150, H0043.

This is a statistical summary, not an accusation. See our methodology.

Compared to Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $481.6M is at the 99th percentile among 19 Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities providers.

Above 99th percentile for this specialty — higher spending than 18 of 19 peers

Active Billing Period:2018-012024-11(83 months)

Total Paid

$481.6M

$481,636,326

Total Claims

89K

Beneficiaries

70K

1.3 claims/patient

Avg Cost/Claim

$5K

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

🔍 Analysis

Provider Overview

Wall Residences LLC is a Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities provider based in Floyd, VA. From the 2018–2024 period, this provider received $481.6M in Medicaid payments across 89K claims.

Why This Matters

This provider received $481.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 60,204 Medicaid beneficiaries for a full year at average per-enrollee costs.

67% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$49.5M
+12%
2019
$55.2M
+8%
2020
$59.4M
+13%
2021
$67.3M
+18%
2022
$79.4M
+11%
2023
$88.3M
-7%
2024
$82.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (T2033 (Residential care, NOS; per diem)) accounts for 57% of total spending.

T2033Top 10%

Residential care, NOS; per diem

$272.5M

43K claims · 56.6%

Your Cost: $6,295.99/claim|Median: $1,051.57
6.0× median
H2022Top 5%

Community-based wrap-around services, per diem

$178.8M

22K claims · 37.1%

Your Cost: $8,178.90/claim|Median: $336.31
24.3× median
T2021Top 10%

Day habilitation, waiver; per 15 min

$12.2M

11K claims · 2.5%

Your Cost: $1,118.99/claim|Median: $150.51
7.4× median
T2013Top 10%

Habilitation, residential, waiver, per hour

$5.3M

3K claims · 1.1%

Your Cost: $1,675.75/claim|Median: $158.23
10.6× median
H2014Top 5%

Skills training & development, per 15 min

$5.2M

3K claims · 1.1%

Your Cost: $2,045.85/claim|Median: $83.88
24.4× median
97127Top 1%

$2.0M

2K claims · 0.4%

Your Cost: $1,260.10/claim|Median: $66.78
18.9× median
97139Top 5%

$1.8M

3K claims · 0.4%

Your Cost: $670.33/claim|Median: $28.71
23.4× median
T2016Top 5%

Habilitation, residential, waiver; per diem

$1.2M

149 claims · 0.2%

Your Cost: $7,840.24/claim|Median: $331.94
23.6× median
97150Top 1%

Therapeutic procedure, group (2+ patients)

$942K

649 claims · 0.2%

Your Cost: $1,452.03/claim|Median: $12.12
119.8× median
S9124Top 5%

Nursing care, in the home; per hour

$906K

671 claims · 0.2%

Your Cost: $1,350.94/claim|Median: $400.25
3.4× median
H0043Top 1%

Supported housing, per diem

$499K

89 claims · 0.1%

Your Cost: $5,606.26/claim|Median: $164.87
34.0× median
97530Top 1%

Therapeutic activities, each 15 min

$123K

273 claims · 0.0%

Your Cost: $450.16/claim|Median: $33.11
13.6× median
S9123Normal range

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

$108K

1K claims · 0.0%

Your Cost: $106.84/claim|Median: $124.86
0.9× median
97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$69K

527 claims · 0.0%

Your Cost: $131.65/claim|Median: $167.38
0.8× median
97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$18K

127 claims · 0.0%

Your Cost: $139.32/claim|Median: $146.45
0.9× median