Wall Residences LLC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $8,178.90 per claim for H2022 (Community-based wrap-around services, per diem), which is 24.3× the national median of $336.31.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 12 procedure codes: T2033 at 6.0× median, H2022 at 24.3× 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
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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.
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
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
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.
Monthly Spending Trend
Yearly Spending
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.
$272.5M
43K claims
$6,295.99
$1,051.57
Residential care, NOS; per diem
$272.5M
43K claims · 56.6%
$178.8M
22K claims
$8,178.90
$336.31
Community-based wrap-around services, per diem
$178.8M
22K claims · 37.1%
$12.2M
11K claims
$1,118.99
$150.51
Day habilitation, waiver; per 15 min
$12.2M
11K claims · 2.5%
$5.3M
3K claims
$1,675.75
$158.23
Habilitation, residential, waiver, per hour
$5.3M
3K claims · 1.1%
$5.2M
3K claims
$2,045.85
$83.88
Skills training & development, per 15 min
$5.2M
3K claims · 1.1%
$2.0M
2K claims · 0.4%
$1.8M
3K claims · 0.4%
$1.2M
149 claims
$7,840.24
$331.94
Habilitation, residential, waiver; per diem
$1.2M
149 claims · 0.2%
$942K
649 claims
$1,452.03
$12.12
Therapeutic procedure, group (2+ patients)
$942K
649 claims · 0.2%
$906K
671 claims
$1,350.94
$400.25
Nursing care, in the home; per hour
$906K
671 claims · 0.2%
Supported housing, per diem
$499K
89 claims · 0.1%
Therapeutic activities, each 15 min
$123K
273 claims · 0.0%
$108K
1K claims
$106.84
$124.86
Nursing care, in the home, by RN, per 15 minutes
$108K
1K claims · 0.0%
$69K
527 claims
$131.65
$167.38
Adaptive behavior treatment by protocol, per 15 min
$69K
527 claims · 0.0%
$18K
127 claims
$139.32
$146.45
Adaptive behavior treatment with protocol modification, per 15 minutes
$18K
127 claims · 0.0%
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