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

Accentcare of New York, Inc.

Home Health·Yonkers, NY·NPI: 1386751162SharePrint 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:

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

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

Risk Assessment

Bills $351.87 per claim for 99199 (Unlisted special service, procedure, or report) — 65.3× the national median of $5.39.

Billing above the 90th percentile for 2 procedure codes simultaneously.

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

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $264.8M is at the 75th percentile among 322 Home Health providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$264.8M

$264,796,678

Total Claims

1.5M

Beneficiaries

71K

20.7 claims/patient

Avg Cost/Claim

$179

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

🔍 Analysis

Provider Overview

Accentcare of New York, Inc. is a Home Health provider based in Yonkers, NY. From the 2018–2024 period, this provider received $264.8M in Medicaid payments across 1.5M claims.

Why This Matters

This provider received $264.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 33,099 Medicaid beneficiaries for a full year at average per-enrollee costs.

8% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$26.7M
+73%
2019
$46.1M
+33%
2020
$61.2M
-0%
2021
$61.1M
-66%
2022
$20.9M
+16%
2023
$24.1M
+2%
2024
$24.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 9 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 90% of total spending.

T1019Top 25%

Personal care services, per 15 min

$237.8M

1.4M claims · 89.8%

Your Cost: $171.58/claim|Median: $82.47
2.1× median
T1020Normal range

Personal care services, per diem

$26.4M

85K claims · 10.0%

Your Cost: $309.04/claim|Median: $296.27
1.0× median
S5125Top 25%

Attendant care services, per 15 min

$288K

2K claims · 0.1%

Your Cost: $165.46/claim|Median: $82.34
2.0× median
S5126Normal range

Attendant care services, per diem

$162K

871 claims · 0.1%

Your Cost: $185.77/claim|Median: $156.98
1.2× median
G0162Top 25%

Skilled services by RN in home health, per 15 min

$70K

578 claims · 0.0%

Your Cost: $120.54/claim|Median: $59.83
2.0× median
T1022Top 5%

$32K

107 claims · 0.0%

Your Cost: $295.84/claim|Median: $184.03
1.6× median
99199Top 5%

Unlisted special service, procedure, or report

$26K

75 claims · 0.0%

Your Cost: $351.87/claim|Median: $5.39
65.3× median
T1001Top 25%

Nursing assessment/evaluation, per visit

$20K

229 claims · 0.0%

Your Cost: $86.72/claim|Median: $49.05
1.8× median
S9123Normal range

Nursing care, in the home, by RN, per 15 minutes

$13K

221 claims · 0.0%

Your Cost: $60.00/claim|Median: $124.86
0.5× median