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Springwell

Case Management·Watertown, MA·NPI: 1184758310Share

Compared to Case Management Peers

Total spending distribution among 137 providers in this specialty

P25MedianP75P90

This provider's total spending of $153.8M is at the 50th percentile among 137 Case Management providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$153.8M

$153,840,066

Total Claims

512K

Beneficiaries

128K

4.0 claims/patient

Avg Cost/Claim

$300

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

🔍 Analysis

Provider Overview

Springwell is a Case Management provider based in Watertown, MA. From the 2018–2024 period, this provider received $153.8M in Medicaid payments across 512K claims.

Important Context

  • ℹ️This provider appears to operate as a fiscal intermediary or management organization, processing payments on behalf of many individual caregivers. High aggregate billing is expected for this type of entity.

Why This Matters

This provider received $153.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,230 Medicaid beneficiaries for a full year at average per-enrollee costs.

↓ 52% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$17.1M
+29%
2019
$22.0M
+5%
2020
$23.2M
+19%
2021
$27.5M
+14%
2022
$31.5M
-23%
2023
$24.2M
-66%
2024
$8.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 24 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 34% of total spending.

T1019Top 5%

Personal care services, per 15 min

$52.0M

92K claims · 33.8%

Your Cost: $568.54/claim|Median: $82.47
6.9× median
G0156Top 1%

Home health aide services, per visit

$43.3M

17K claims · 28.1%

Your Cost: $2,488.35/claim|Median: $39.42
63.1× median
S5130Top 10%

Homemaker service, NOS; per 15 min

$39.9M

124K claims · 25.9%

Your Cost: $321.28/claim|Median: $48.76
6.6× median
S5102Top 10%

Day care services, adult; per 15 min

$6.4M

35K claims · 4.2%

Your Cost: $183.96/claim|Median: $81.10
2.3× median
S5170Normal range

Homemaker service, NOS, per diem

$4.0M

141K claims · 2.6%

Your Cost: $28.58/claim|Median: $19.89
1.4× median
T2003Top 10%

Non-emergency transport; encounter/trip

$3.2M

32K claims · 2.1%

Your Cost: $100.63/claim|Median: $21.70
4.6× median
S5135Top 5%

Companion care, adult, per diem

$1.8M

6K claims · 1.2%

Your Cost: $317.98/claim|Median: $52.25
6.1× median
S5175Top 25%

Laundry service, per occasion

$973K

23K claims · 0.6%

Your Cost: $43.25/claim|Median: $30.40
1.4× median
S5120Top 25%

Chore services, per 15 min

$710K

6K claims · 0.5%

Your Cost: $121.32/claim|Median: $70.19
1.7× median
S5161Normal range

Emergency response system, per month

$543K

22K claims · 0.4%

Your Cost: $24.66/claim|Median: $29.97
0.8× median
S5101Normal range

Day care services, adult, per half day

$281K

4K claims · 0.2%

Your Cost: $68.40/claim|Median: $66.43
1.0× median
T1013Top 5%

Sign language or oral interpretive services, per 15 minutes

$115K

713 claims · 0.1%

Your Cost: $161.14/claim|Median: $17.67
9.1× median
S5165Normal range

Home modifications, per service

$86K

462 claims · 0.1%

Your Cost: $185.65/claim|Median: $2,196.32
0.1× median
G0299Top 25%

Skilled nursing services, home health, per visit, RN

$80K

855 claims · 0.1%

Your Cost: $93.52/claim|Median: $51.67
1.8× median
H0046Normal range

Mental health services, not otherwise specified

$72K

2K claims · 0.0%

Your Cost: $29.32/claim|Median: $85.02
0.3× median
G9001Normal range

$65K

1K claims · 0.0%

Your Cost: $65.00/claim|Median: $53.98
1.2× median
T1020Normal range

Personal care services, per diem

$64K

1K claims · 0.0%

Your Cost: $49.15/claim|Median: $296.27
0.2× median
S5121Normal range

Attendant care services, in-home, per 15 min

$49K

2K claims · 0.0%

Your Cost: $30.12/claim|Median: $111.06
0.3× median
T1023Normal range

Screening to determine appropriateness of consideration for program

$38K

317 claims · 0.0%

Your Cost: $121.19/claim|Median: $106.70
1.1× median
A9279Normal range

$22K

552 claims · 0.0%

Your Cost: $40.51/claim|Median: $10.45
3.9× median
T2022Normal range

Case management, per month

$19K

324 claims · 0.0%

Your Cost: $58.81/claim|Median: $202.77
0.3× median
S5160Normal range

Emergency response system, per month

$4K

122 claims · 0.0%

Your Cost: $31.27/claim|Median: $38.52
0.8× median
96160Top 1%

Patient-focused health risk assessment

$950

12 claims · 0.0%

Your Cost: $79.17/claim|Median: $2.10
37.7× median
G9002Normal range

Coordinated care fee, maintenance period

$751

1K claims · 0.0%

Your Cost: $0.75/claim|Median: $108.80
0.0× median

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