Howard Center INC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $1,324.36 per claim for H2022 (Community-based wrap-around services, per diem), which is 3.9× the national median of $336.31.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 1 procedure codes: 99199 at 1058.4× 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.
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 $5,704.61 per claim for 99199 (Unlisted special service, procedure, or report) — 1058.4× the national median of $5.39.
Bills $1,324.36 per claim for H2022 (Community-based wrap-around services, per diem) — 3.9× the national median of $336.31.
Billing in the top 1% nationally for 1 procedure code: 99199.
This is a statistical summary, not an accusation. See 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 $332.2M is at the 90th percentile among 22 Day Training Developmentally Disabled Services providers.
Above 90th percentile for this specialty — higher spending than 19 of 22 peers
Total Paid
$332.2M
$332,176,357
Total Claims
898K
Beneficiaries
145K
6.2 claims/patient
Avg Cost/Claim
$370
#212 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Howard Center INC is a Day Training Developmentally Disabled Services provider based in Burlington, VT. From the 2018–2024 period, this provider received $332.2M in Medicaid payments across 898K claims.
Why This Matters
This provider received $332.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 41,522 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 (99199 (Unlisted special service, procedure, or report)) accounts for 68% of total spending.
$224.8M
39K claims
$5,704.61
$5.39
Unlisted special service, procedure, or report
$224.8M
39K claims · 67.7%
$107.3M
81K claims
$1,324.36
$336.31
Community-based wrap-around services, per diem
$107.3M
81K claims · 32.3%
$3K
852 claims
$3.40
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$3K
852 claims · 0.0%
$2K
607 claims
$3.38
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$2K
607 claims · 0.0%
Psychotherapy, 30 minutes
$1K
2K claims · 0.0%
Psychotherapy, 60 minutes
$192
1K claims · 0.0%
Psychotherapy, 45 minutes
$87
750 claims · 0.0%
$41
185 claims · 0.0%
Supported employment, per 15 min
$0
18K claims · 0.0%
$0
201 claims
$0.00
$215.80
Crisis intervention service, per 15 minutes
$0
201 claims · 0.0%
Unskilled respite care, per 15 min
$0
54K claims · 0.0%
Emergency response system, per month
$0
6K claims · 0.0%
Day habilitation, waiver; per 15 min
$0
184K claims · 0.0%
$0
3K claims · 0.0%
$0
4K claims
$0.00
$100.49
Ongoing support to maintain employment, per 15 min
$0
4K claims · 0.0%
$0
19K claims
$0.00
$137.32
Habilitation, residential, waiver; 15 min
$0
19K claims · 0.0%
Unskilled respite care, per diem
$0
12K claims · 0.0%
Psychiatric diagnostic evaluation
$0
88 claims · 0.0%
Foster care, adult; per diem
$0
149K claims · 0.0%
$0
22K claims
$0.00
$331.94
Habilitation, residential, waiver; per diem
$0
22K claims · 0.0%
Residential care, NOS; per diem
$0
18K claims · 0.0%
Activity therapy, per 15 minutes
$0
812 claims · 0.0%
Targeted case management, per 15 min
$0
126 claims · 0.0%
Waiver services, NOS; per 15 min
$0
1K claims · 0.0%
Case management, each 15 min
$0
280K claims · 0.0%
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