Rem Community Options Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $3,739.07 per claim for S5125 (Attendant care services, per 15 min), which is 45.4× the national median of $82.34.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 7 procedure codes: S5125 at 45.4× median, T1002 at 8.1× 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:
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.
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 $3,739.07 per claim for S5125 (Attendant care services, per 15 min) — 45.4× the national median of $82.34.
Bills $302.75 per claim for T1002 (RN services, per 15 minutes) — 8.1× the national median of $37.42.
Bills $161.60 per claim for T1016 (Case management, each 15 min) — 3.3× the national median of $49.62.
Billing in the top 1% nationally for 2 procedure codes: S5125, 97530.
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 $224.9M is at the 75th percentile among 218 Community/Behavioral Health providers.
Total Paid
$224.9M
$224,864,470
Total Claims
213K
Beneficiaries
162K
1.3 claims/patient
Avg Cost/Claim
$1K
#375 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Rem Community Options Inc. is a Community/Behavioral Health provider based in Benwood, WV. From the 2018–2024 period, this provider received $224.9M in Medicaid payments across 213K claims.
Why This Matters
This provider received $224.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 28,108 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 13 distinct procedure codes. The top code (S5125 (Attendant care services, per 15 min)) accounts for 84% of total spending.
$188.4M
50K claims
$3,739.07
$82.34
Attendant care services, per 15 min
$188.4M
50K claims · 83.8%
$8.7M
32K claims
$267.30
$150.51
Day habilitation, waiver; per 15 min
$8.7M
32K claims · 3.9%
RN services, per 15 minutes
$5.4M
18K claims · 2.4%
$5.3M
25K claims
$209.53
$108.80
Coordinated care fee, maintenance period
$5.3M
25K claims · 2.4%
Case management, each 15 min
$4.4M
27K claims · 2.0%
Respite care services, per 15 minutes
$3.9M
5K claims · 1.7%
LPN/LVN services, per 15 minutes
$3.6M
16K claims · 1.6%
$2.3M
17K claims · 1.0%
Therapeutic activities, each 15 min
$904K
3K claims · 0.4%
Non-emergency mini-bus transport
$772K
7K claims · 0.3%
$650K
10K claims
$65.05
$259.38
Supported employment, waiver, per diem
$650K
10K claims · 0.3%
$456K
917 claims
$497.24
$88.91
Habilitation, prevocational, waiver; per 15 min
$456K
917 claims · 0.2%
Speech/hearing/language treatment
$75K
1K claims · 0.0%
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