Berry Family Services
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $174K (2020) to $23.5M (2021) — a 13430% swing with $23.4M absolute change.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 13430% from 2020 to 2021.
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:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $410.57 per claim for D0120 (Periodic oral evaluation, established patient) — 16.9× the national median of $24.34.
Bills $71.74 per claim for S5199 (Personal care item, NOS, each) — 6.6× the national median of $10.82.
Billing in the top 1% nationally for 2 procedure codes: M0354, D0120.
This is a statistical summary, not an accusation. See our methodology.
Compared to Case Management Peers
Total spending distribution among 137 providers in this specialty
This provider's total spending of $128.7M is at the 50th percentile among 137 Case Management providers.
Total Paid
$128.7M
$128,748,229
Total Claims
1.0M
Beneficiaries
117K
8.6 claims/patient
Avg Cost/Claim
$128
#908 of 618K providers by total spending(top 0.1%)
🔍 Analysis
Provider Overview
Berry Family Services is a Case Management provider based in Rowlett, TX. From the 2018–2024 period, this provider received $128.7M in Medicaid payments across 1.0M claims.
Important Context
- ℹ️This provider appears to operate as a fiscal intermediary or management organization, processing payments on behalf of many individual caregivers. High aggregate billing is expected for this type of entity.
Why This Matters
This provider received $128.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,093 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 30 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 49% of total spending.
$63.6M
121K claims
$524.45
$321.53
Comprehensive community support services, per 15 min
$63.6M
121K claims · 49.4%
$11.5M
82K claims
$139.97
$331.94
Habilitation, residential, waiver; per diem
$11.5M
82K claims · 8.9%
$8.9M
117K claims · 6.9%
$8.3M
176K claims
$47.07
$83.88
Skills training & development, per 15 min
$8.3M
176K claims · 6.4%
$4.7M
50K claims · 3.6%
$3.8M
32K claims · 3.0%
$3.7M
51K claims · 2.9%
$3.4M
84K claims
$40.60
$87.34
Day habilitation, waiver; per diem
$3.4M
84K claims · 2.7%
$3.1M
19K claims · 2.4%
$2.7M
23K claims · 2.1%
$2.4M
19K claims
$124.26
$84.46
Unskilled respite care, per 15 min
$2.4M
19K claims · 1.9%
$1.6M
47K claims · 1.2%
$1.2M
10K claims · 1.0%
$1.2M
3K claims
$410.57
$24.34
Periodic oral evaluation, established patient
$1.2M
3K claims · 0.9%
$1.1M
27K claims · 0.8%
$913K
19K claims · 0.7%
$787K
5K claims · 0.6%
$754K
11K claims
$71.80
$124.39
Waiver services, NOS; per 15 min
$754K
11K claims · 0.6%
$658K
5K claims
$127.48
$84.12
Therapeutic behavioral services, per 15 min
$658K
5K claims · 0.5%
$511K
1K claims · 0.4%
LPN/LVN services, per 15 minutes
$453K
13K claims · 0.4%
$431K
14K claims · 0.3%
RN services, per 15 minutes
$419K
16K claims · 0.3%
$311K
4K claims · 0.2%
$273K
4K claims · 0.2%
$260K
9K claims · 0.2%
$257K
3K claims · 0.2%
Personal care item, NOS, each
$205K
3K claims · 0.2%
$183K
9K claims · 0.1%
$175K
2K claims · 0.1%
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