A Circle of Care Colorado Llc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $268.78 per claim for H0038 (Self-help/peer services, per 15 minutes), which is 4.9× the national median of $55.04.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T2034 (2 unique codes).
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.
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Extreme procedure concentration — 100% of all billing flows through just 2 codes (H0038, T2034).
This is a statistical summary, not an accusation. See our methodology.
Compared to In Home Supportive Care Peers
Total spending distribution among 57 providers in this specialty
This provider's total spending of $101.7M is at the 50th percentile among 57 In Home Supportive Care providers.
Extreme procedure concentration — 100% of $101.7M billed through just 2 codes
Total Paid
$101.7M
$101,668,632
Total Claims
0
Beneficiaries
0
Avg Cost/Claim
$0
🔍 Analysis
Provider Overview
A Circle of Care Colorado Llc. is a In Home Supportive Care provider based in Colorado Springs, CO. From the 2018–2024 period, this provider received $0 in Medicaid payments across 0 claims.
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 2 distinct procedure codes. The top code (H0038 (Self-help/peer services, per 15 minutes)) accounts for 100% of total spending.
Self-help/peer services, per 15 minutes
$101.7M
378K claims · 100.0%
Crisis intervention, per 15 min
$0
25 claims · 0.0%
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