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

Rscr West Virginia Inc.

Clinic/Center Developmental Disabilities·Parkersburg, WV·NPI: 1255496220SharePrint 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.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Bills $3,362.37 per claim for S5125 (Attendant care services, per 15 min) — 40.8× the national median of $82.34.

Bills $200.66 per claim for T1003 (LPN/LVN services, per 15 minutes) — 8.3× the national median of $24.24.

Bills $104.46 per claim for A0160 — 8.3× the national median of $12.60.

Billing in the top 1% nationally for 3 procedure codes: S5125, 97530, 92507.

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

Compared to Clinic/Center Developmental Disabilities Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $153.6M is at the 25th percentile among 10 Clinic/Center Developmental Disabilities providers.

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

Total Paid

$153.6M

$153,607,410

Total Claims

114K

Beneficiaries

74K

1.6 claims/patient

Avg Cost/Claim

$1K

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

🔍 Analysis

Provider Overview

Rscr West Virginia Inc. is a Clinic/Center Developmental Disabilities provider based in Parkersburg, WV. From the 2018–2024 period, this provider received $153.6M in Medicaid payments across 114K claims.

Why This Matters

This provider received $153.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,200 Medicaid beneficiaries for a full year at average per-enrollee costs.

38% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$25.8M
-6%
2019
$24.3M
-13%
2020
$21.1M
+12%
2021
$23.6M
-10%
2022
$21.1M
+3%
2023
$21.9M
-27%
2024
$15.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (S5125 (Attendant care services, per 15 min)) accounts for 94% of total spending.

S5125Top 1%

Attendant care services, per 15 min

$144.1M

43K claims · 93.8%

Your Cost: $3,362.37/claim|Median: $82.34
40.8× median
T1003Normal range

LPN/LVN services, per 15 minutes

$2.9M

14K claims · 1.9%

Your Cost: $200.66/claim|Median: $24.24
8.3× median
T2021Normal range

Day habilitation, waiver; per 15 min

$1.6M

15K claims · 1.1%

Your Cost: $107.45/claim|Median: $150.51
0.7× median
T1016Top 25%

Case management, each 15 min

$1.3M

9K claims · 0.8%

Your Cost: $142.37/claim|Median: $49.62
2.9× median
A0160Top 10%

$1.2M

12K claims · 0.8%

Your Cost: $104.46/claim|Median: $12.60
8.3× median
G9002Top 25%

Coordinated care fee, maintenance period

$1.1M

6K claims · 0.7%

Your Cost: $189.26/claim|Median: $108.80
1.7× median
T1002Top 25%

RN services, per 15 minutes

$1.1M

11K claims · 0.7%

Your Cost: $102.54/claim|Median: $37.42
2.7× median
T2024Normal range

Supported employment, waiver, per diem

$252K

5K claims · 0.2%

Your Cost: $52.99/claim|Median: $259.38
0.2× median
97530Top 1%

Therapeutic activities, each 15 min

$34K

133 claims · 0.0%

Your Cost: $258.08/claim|Median: $33.11
7.8× median
A0120Top 10%

Non-emergency mini-bus transport

$32K

206 claims · 0.0%

Your Cost: $155.51/claim|Median: $16.09
9.7× median
92507Top 1%

Speech/hearing/language treatment

$8K

51 claims · 0.0%

Your Cost: $155.84/claim|Median: $49.45
3.1× median
97802Normal range

Medical nutrition therapy, reassessment, individual, fifteen minutes

$1K

33 claims · 0.0%

Your Cost: $45.45/claim|Median: $12.70
3.6× median