Chimes Metro Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $406.06 per claim for T2025 (Waiver services, NOS; per 15 min), which is 3.3× the national median of $124.39.
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.
Risk Assessment
Bills $406.06 per claim for T2025 (Waiver services, NOS; per 15 min) — 3.3× the national median of $124.39.
This is a statistical summary, not an accusation. See our methodology.
Compared to Psychologist Intellectual & Developmental Disabilities Peers
Total spending distribution among 6 providers in this specialty
This provider's total spending of $174.0M is at the 50th percentile among 6 Psychologist Intellectual & Developmental Disabilities providers.
Total Paid
$174.0M
$173,976,281
Total Claims
823K
Beneficiaries
51K
16.3 claims/patient
Avg Cost/Claim
$211
#560 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Chimes Metro Inc. is a Psychologist Intellectual & Developmental Disabilities provider based in Newark, DE. From the 2018–2024 period, this provider received $174.0M in Medicaid payments across 823K claims.
Why This Matters
This provider received $174.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,747 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 (T2025 (Waiver services, NOS; per 15 min)) accounts for 65% of total spending.
Waiver services, NOS; per 15 min
$113.1M
278K claims · 65.0%
$27.5M
66K claims
$413.55
$331.94
Habilitation, residential, waiver; per diem
$27.5M
66K claims · 15.8%
$17.4M
177K claims
$98.29
$87.34
Day habilitation, waiver; per diem
$17.4M
177K claims · 10.0%
$5.5M
46K claims
$120.80
$88.91
Habilitation, prevocational, waiver; per 15 min
$5.5M
46K claims · 3.2%
$5.1M
74K claims
$69.29
$74.75
Habilitation, prevocational, waiver, per hour
$5.1M
74K claims · 2.9%
$1.6M
25K claims
$63.63
$150.51
Day habilitation, waiver; per 15 min
$1.6M
25K claims · 0.9%
$1.3M
38K claims
$33.98
$49.05
Nursing assessment/evaluation, per visit
$1.3M
38K claims · 0.7%
$1.1M
27K claims
$41.45
$88.27
Habilitation, prevocational, waiver, per diem
$1.1M
27K claims · 0.6%
$711K
22K claims · 0.4%
$563K
67K claims
$8.34
$8.80
Non-emergency transportation, commercial carrier, encounter trip
$563K
67K claims · 0.3%
Supported employment, per 15 min
$110K
2K claims · 0.1%
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