Disability Services of the Southwest, INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 5 procedure codes: 97124 at 5.0× median, 97113 at 2.3× 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.
Risk Assessment
Bills $89.60 per claim for 97124 — 5.0× the national median of $17.78.
Bills $519.71 per claim for E1399 (Durable medical equipment, miscellaneous) — 5.0× the national median of $104.06.
Bills $628.43 per claim for D9999 (Unspecified adjunctive procedure, by report) — 16.7× the national median of $37.60.
Billing in the top 1% nationally for 1 procedure code: D9220.
This is a statistical summary, not an accusation. See our methodology.
Compared to Day Training, Developmentally Disabled Services Peers
Total spending distribution among 56 providers in this specialty
This provider's total spending of $302.3M is at the 90th percentile among 56 Day Training, Developmentally Disabled Services providers.
Above 90th percentile for this specialty — higher spending than 50 of 56 peers
Total Paid
$302.3M
$302,345,323
Total Claims
3.1M
Beneficiaries
397K
7.9 claims/patient
Avg Cost/Claim
$97
#242 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Disability Services of the Southwest, INC is a Day Training, Developmentally Disabled Services provider based in San Antonio, TX. From the 2018–2024 period, this provider received $302.3M in Medicaid payments across 3.1M claims.
Why This Matters
This provider received $302.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 37,793 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 25 distinct procedure codes. The top code (T2026 (Specialized transportation, waiver, per trip)) accounts for 57% of total spending.
$173.7M
1.3M claims
$137.59
$170.05
Specialized transportation, waiver, per trip
$173.7M
1.3M claims · 57.5%
Activity therapy, per 15 minutes
$36.0M
177K claims · 11.9%
$31.8M
355K claims · 10.5%
$11.6M
136K claims
$84.85
$85.09
Activity therapy (group), per session
$11.6M
136K claims · 3.8%
$9.1M
105K claims
$86.46
$88.27
Habilitation, prevocational, waiver, per diem
$9.1M
105K claims · 3.0%
$8.7M
730K claims · 2.9%
$6.9M
128K claims
$53.70
$82.34
Attendant care services, per 15 min
$6.9M
128K claims · 2.3%
$4.1M
35K claims · 1.4%
$3.7M
65K claims · 1.2%
$3.6M
40K claims · 1.2%
$2.8M
5K claims
$519.71
$104.06
Durable medical equipment, miscellaneous
$2.8M
5K claims · 0.9%
$2.8M
18K claims
$158.28
$84.12
Therapeutic behavioral services, per 15 min
$2.8M
18K claims · 0.9%
$2.7M
4K claims
$628.43
$37.60
Unspecified adjunctive procedure, by report
$2.7M
4K claims · 0.9%
$1.1M
957 claims · 0.4%
$1.0M
13K claims
$81.72
$67.94
Physical therapy services, home health, per visit
$1.0M
13K claims · 0.3%
$912K
11K claims
$79.45
$101.43
Services of SLP in home health, per 15 min
$912K
11K claims · 0.3%
RN services, per 15 minutes
$763K
15K claims · 0.3%
Case management, per month
$337K
1K claims · 0.1%
$163K
895 claims
$182.55
$249.18
Unskilled respite care, per diem
$163K
895 claims · 0.1%
Case management, each 15 min
$158K
5K claims · 0.1%
$103K
8K claims
$13.18
$259.38
Supported employment, waiver, per diem
$103K
8K claims · 0.0%
$89K
3K claims
$30.00
$29.97
Emergency response system, per month
$89K
3K claims · 0.0%
$85K
448 claims
$190.64
$106.70
Screening to determine appropriateness of consideration for program
$85K
448 claims · 0.0%
$65K
801 claims
$81.44
$68.93
Occupational therapy services, home health, per visit
$65K
801 claims · 0.0%
$54K
274 claims
$196.57
$21.70
Non-emergency transport; encounter/trip
$54K
274 claims · 0.0%
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