Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

The Arc of Union County

Day Training, Developmentally Disabled Services·Springfield, NJ·NPI: 1902286214SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

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 56 providers in this specialty

P25MedianP75P90

This provider's total spending of $155.5M is at the 75th percentile among 56 Day Training, Developmentally Disabled Services providers.

Active Billing Period:2018-062024-12(79 months)

Total Paid

$155.5M

$155,519,097

Total Claims

459K

Beneficiaries

26K

17.3 claims/patient

Avg Cost/Claim

$339

#682 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

The Arc of Union County is a Day Training, Developmentally Disabled Services provider based in Springfield, NJ. From the 2018–2024 period, this provider received $155.5M in Medicaid payments across 459K claims.

Important Context

  • 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 $155.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,439 Medicaid beneficiaries for a full year at average per-enrollee costs.

261% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$7.8M
+207%
2019
$24.0M
-15%
2020
$20.4M
+12%
2021
$22.8M
+9%
2022
$24.9M
+10%
2023
$27.3M
+3%
2024
$28.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 7 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 73% of total spending.

H2016Normal range

Comprehensive community support services, per 15 min

$114.0M

202K claims · 73.3%

Your Cost: $563.01/claim|Median: $321.53
1.8× median
T2021Normal range

Day habilitation, waiver; per 15 min

$40.1M

232K claims · 25.8%

Your Cost: $173.22/claim|Median: $150.51
1.1× median
T1005Normal range

Respite care services, per 15 minutes

$896K

14K claims · 0.6%

Your Cost: $63.15/claim|Median: $71.40
0.9× median
T2015Normal range

Habilitation, prevocational, waiver, per diem

$345K

6K claims · 0.2%

Your Cost: $60.72/claim|Median: $88.27
0.7× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$165K

5K claims · 0.1%

Your Cost: $36.33/claim|Median: $74.63
0.5× median
A0090Normal range

Non-emergency transport, per mile

$7K

371 claims · 0.0%

Your Cost: $17.88/claim|Median: $10.45
1.7× median
H2015Normal range

Comprehensive community support services, per 15 min

$2K

106 claims · 0.0%

Your Cost: $20.59/claim|Median: $96.24
0.2× median