North Metro Community Services Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $3,647.98 per claim for T2016 (Habilitation, residential, waiver; per diem), which is 11.0× the national median of $331.94.
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.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Day Training Developmentally Disabled Services Peers
Total spending distribution among 22 providers in this specialty
This provider's total spending of $107.7M is at the 25th percentile among 22 Day Training Developmentally Disabled Services providers.
Total Paid
$107.7M
$107,748,727
Total Claims
156K
Beneficiaries
108K
1.4 claims/patient
Avg Cost/Claim
$691
🔍 Analysis
Provider Overview
North Metro Community Services Inc. is a Day Training Developmentally Disabled Services provider based in Westminster, CO. From the 2018–2024 period, this provider received $107.7M in Medicaid payments across 156K claims.
Why This Matters
This provider received $107.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 13,468 Medicaid beneficiaries for a full year at average per-enrollee costs.
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