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

Community Bridges

Case Management·Concord, NH·NPI: 1962564328SharePrint 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:

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 $965.57 per claim for T2025 (Waiver services, NOS; per 15 min) — 7.8× the national median of $124.39.

Bills $524.65 per claim for H2032 (Activity therapy, per 15 minutes) — 4.8× the national median of $108.23.

Billing above the 90th percentile for 2 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

P25MedianP75P90

This provider's total spending of $265.5M is at the 75th percentile among 137 Case Management providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$265.5M

$265,469,407

Total Claims

970K

Beneficiaries

122K

8.0 claims/patient

Avg Cost/Claim

$274

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

🔍 Analysis

Provider Overview

Community Bridges is a Case Management provider based in Concord, NH. From the 2018–2024 period, this provider received $265.5M in Medicaid payments across 970K 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.

Why This Matters

This provider received $265.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 33,183 Medicaid beneficiaries for a full year at average per-enrollee costs.

38% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$36.0M
+4%
2019
$37.5M
+6%
2020
$39.6M
+25%
2021
$49.5M
-3%
2022
$48.2M
-33%
2023
$32.3M
-31%
2024
$22.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (T1020 (Personal care services, per diem)) accounts for 52% of total spending.

T1020Normal range

Personal care services, per diem

$137.0M

442K claims · 51.6%

Your Cost: $309.75/claim|Median: $296.27
1.1× median
T2025Top 5%

Waiver services, NOS; per 15 min

$54.1M

56K claims · 20.4%

Your Cost: $965.57/claim|Median: $124.39
7.8× median
T2021Normal range

Day habilitation, waiver; per 15 min

$51.2M

320K claims · 19.3%

Your Cost: $160.23/claim|Median: $150.51
1.1× median
T2022Normal range

Case management, per month

$9.6M

43K claims · 3.6%

Your Cost: $225.32/claim|Median: $202.77
1.1× median
T1024Top 25%

Evaluation & treatment, integrated specialty team

$4.1M

17K claims · 1.5%

Your Cost: $240.32/claim|Median: $119.08
2.0× median
T2023Normal range

Community transition, waiver; per service

$3.3M

16K claims · 1.3%

Your Cost: $209.20/claim|Median: $300.13
0.7× median
H2015Normal range

Comprehensive community support services, per 15 min

$2.3M

32K claims · 0.9%

Your Cost: $71.38/claim|Median: $96.24
0.7× median
T1005Normal range

Respite care services, per 15 minutes

$1.6M

20K claims · 0.6%

Your Cost: $81.91/claim|Median: $71.40
1.1× median
H2023Normal range

Supported employment, per 15 min

$1.5M

22K claims · 0.6%

Your Cost: $71.58/claim|Median: $103.94
0.7× median
H2011Normal range

Crisis intervention service, per 15 minutes

$509K

2K claims · 0.2%

Your Cost: $268.57/claim|Median: $215.80
1.2× median
H2019Normal range

Therapeutic behavioral services, per 15 min

$99K

1K claims · 0.0%

Your Cost: $79.82/claim|Median: $84.12
0.9× median
H2032Top 5%

Activity therapy, per 15 minutes

$69K

132 claims · 0.0%

Your Cost: $524.65/claim|Median: $108.23
4.8× median
T2002Top 25%

Non-emergency transport; per trip

$9K

186 claims · 0.0%

Your Cost: $49.67/claim|Median: $19.35
2.6× median
H2014Normal range

Skills training & development, per 15 min

$269

22 claims · 0.0%

Your Cost: $12.22/claim|Median: $83.88
0.1× median