Assistcarehome Healthcare Services
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: T1031 at 1.8× median, 99199 at 40.6× median.
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:
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.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $218.66 per claim for 99199 (Unlisted special service, procedure, or report) — 40.6× the national median of $5.39.
Bills $125.81 per claim for 90471 (Immunization administration, 1 vaccine, percutaneous/ID/SC/IM) — 12.8× the national median of $9.80.
Billing in the top 1% nationally for 1 procedure code: 90471.
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
This provider's total spending of $1.44B is at the 90th percentile among 322 Home Health providers.
Above 90th percentile for this specialty — higher spending than 289 of 322 peers
Total Paid
$1.44B
$1,442,353,044
Total Claims
9.4M
Beneficiaries
462K
20.3 claims/patient
Avg Cost/Claim
$154
#14 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Assistcarehome Healthcare Services is a Home Health provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $1.4B in Medicaid payments across 9.4M claims.
Why This Matters
This provider received $1.4B in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 180,294 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 17 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 88% of total spending.
$1.27B
8.8M claims
$143.44
$82.47
Personal care services, per 15 min
$1.27B
8.8M claims · 87.9%
$168.0M
498K claims
$337.62
$296.27
Personal care services, per diem
$168.0M
498K claims · 11.6%
$3.0M
22K claims
$131.60
$85.62
Nursing care, in the home, by RN, per diem
$3.0M
22K claims · 0.2%
$2.5M
19K claims
$130.62
$124.86
Nursing care, in the home, by RN, per 15 minutes
$2.5M
19K claims · 0.2%
$749K
5K claims
$154.89
$259.38
Supported employment, waiver, per diem
$749K
5K claims · 0.1%
$413K
2K claims · 0.0%
$284K
2K claims
$142.08
$80.56
Nursing care, in the home, by LPN, per diem
$284K
2K claims · 0.0%
$62K
644 claims
$96.26
$49.05
Nursing assessment/evaluation, per visit
$62K
644 claims · 0.0%
Homemaker service, NOS; per 15 min
$51K
537 claims · 0.0%
$51K
234 claims
$218.66
$5.39
Unlisted special service, procedure, or report
$51K
234 claims · 0.0%
$26K
361 claims
$72.92
$90.35
Physical therapy, in the home, per diem
$26K
361 claims · 0.0%
$20K
208 claims
$97.84
$98.75
Social work visit, in the home, per diem
$20K
208 claims · 0.0%
$18K
227 claims
$81.37
$116.67
Home health aide or certified nurse, per hour
$18K
227 claims · 0.0%
$12K
257 claims
$47.89
$59.83
Skilled services by RN in home health, per 15 min
$12K
257 claims · 0.0%
$4K
31 claims
$125.81
$9.80
Immunization administration, 1 vaccine, percutaneous/ID/SC/IM
$4K
31 claims · 0.0%
$0
819 claims · 0.0%
$0
611 claims
$0.00
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$0
611 claims · 0.0%
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