Lifeskills INC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $122.28 per claim for 97535 (Self-care/home management training, per 15 minutes), which is 6.7× the national median of $18.18.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
High Claims Per Patient
Filing an unusually high number of claims per beneficiary compared to peers.
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.
High Cost Per Claim
High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.
High Claims Per Patient
High Claims Per Patient means this provider files an unusually high number of claims per individual patient. This could indicate legitimate intensive treatment or a pattern of billing for services not actually rendered.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $122.28 per claim for 97535 (Self-care/home management training, per 15 minutes) — 6.7× the national median of $18.18.
Bills $366.81 per claim for T1999 (Miscellaneous therapeutic items and supplies) — 12.8× the national median of $28.63.
Billing above the 90th percentile for 2 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Community/Behavioral Health Peers
Total spending distribution among 218 providers in this specialty
This provider's total spending of $168.9M is at the 75th percentile among 218 Community/Behavioral Health providers.
Total Paid
$168.9M
$168,888,495
Total Claims
1.4M
Beneficiaries
174K
8.2 claims/patient
Avg Cost/Claim
$119
#589 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Lifeskills INC is a Community/Behavioral Health provider based in Bowling Green, KY. From the 2018–2024 period, this provider received $168.9M in Medicaid payments across 1.4M claims.
Why This Matters
This provider received $168.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,111 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 (97535 (Self-care/home management training, per 15 minutes)) accounts for 50% of total spending.
$84.5M
691K claims
$122.28
$18.18
Self-care/home management training, per 15 minutes
$84.5M
691K claims · 50.0%
$32.2M
229K claims
$140.55
$331.94
Habilitation, residential, waiver; per diem
$32.2M
229K claims · 19.1%
$16.0M
160K claims
$99.72
$82.47
Personal care services, per 15 min
$16.0M
160K claims · 9.4%
Case management, per month
$12.0M
46K claims · 7.1%
$10.0M
93K claims
$107.36
$107.36
Home care training to home care client, per 15 minutes
$10.0M
93K claims · 5.9%
$5.1M
93K claims
$54.54
$150.51
Day habilitation, waiver; per 15 min
$5.1M
93K claims · 3.0%
$4.8M
48K claims
$100.31
$108.97
Financial management, self-directed; per month
$4.8M
48K claims · 2.8%
$4.3M
63K claims
$69.16
$71.40
Respite care services, per 15 minutes
$4.3M
63K claims · 2.6%
$12K
1K claims
$10.25
$132.62
Assertive community treatment, per diem
$12K
1K claims · 0.0%
$10K
28 claims
$366.81
$28.63
Miscellaneous therapeutic items and supplies
$10K
28 claims · 0.0%
$3K
155 claims
$21.05
$88.91
Habilitation, prevocational, waiver; per 15 min
$3K
155 claims · 0.0%
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