Mississippi Department of Rehabilitaion Svs
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $468.59 per claim for S5125 (Attendant care services, per 15 min), which is 5.7× the national median of $82.34.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 3 procedure codes: S5125 at 5.7× median, S5165 at 4.1× median.
Consistent Billing
Monthly billing amounts show almost no natural variation (CV < 0.1).
Monthly billing coefficient of variation: 0.0679 (near-zero variation).
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.
Consistent Billing
Consistent Billing means this provider's monthly billing amounts show almost no natural variation. Real medical practices tend to have some fluctuation in monthly billing, so unnaturally steady billing can indicate automated or fabricated claims.
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 $468.59 per claim for S5125 (Attendant care services, per 15 min) — 5.7× the national median of $82.34.
Bills $8,950.12 per claim for S5165 (Home modifications, per service) — 4.1× the national median of $2,196.32.
Bills $162.45 per claim for S5170 (Homemaker service, NOS, per diem) — 8.2× the national median of $19.89.
Billing above the 90th percentile for 3 procedure codes simultaneously.
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 $317.2M is at the 75th percentile among 137 Case Management providers.
Total Paid
$317.2M
$317,166,187
Total Claims
782K
Beneficiaries
309K
2.5 claims/patient
Avg Cost/Claim
$406
#227 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Mississippi Department of Rehabilitaion Svs is a Case Management provider based in Jackson, MS. From the 2018–2024 period, this provider received $317.2M in Medicaid payments across 782K 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.
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $317.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 39,645 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 6 distinct procedure codes. The top code (S5125 (Attendant care services, per 15 min)) accounts for 93% of total spending.
$295.6M
631K claims
$468.59
$82.34
Attendant care services, per 15 min
$295.6M
631K claims · 93.2%
Case management, per month
$19.1M
124K claims · 6.0%
Home modifications, per service
$1.5M
168 claims · 0.5%
$920K
26K claims
$34.88
$79.30
Specialized supply, NOS; per unit
$920K
26K claims · 0.3%
Homemaker service, NOS, per diem
$80K
495 claims · 0.0%
$40K
29 claims
$1,371.46
$141.34
Specialized transportation, waiver, per mile, extra
$40K
29 claims · 0.0%
Other Top Providers in Mississippi
View all →State of Mississippi - University of Mississippi Medical Center
General Acute Care Hospital
$506.7M
Statewide Healthcare Services, INC
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$146.0M
Mississippi Department of Rehabilitaion Services
Case Management
$127.0M
Brandi's Hope Community Services
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$124.6M
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