Somerville Cambridge Elder Services

Somerville Cambridge Elder Services was paid $27.05M by Medicaid between Jan 2018 and Oct 2024, across 3 billing codes. Its largest line is S5140, Foster care, adult; per diem — 100% of everything it billed.

33Billing provider infoSOMERVILLE CAMBRIDGE ELDER SERVICES
SOMERVILLE, MA 02143

33aNPI1154455020assigned 03/15/2007

33bProvider typeCase Management Agency

28Total paid$27.05M

24GClaims138,498

24DCodes billed3

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Case Management Agency providers in Massachusetts

Rank by total paid#51 of 139

Median peer was paid$11.53M

This provider vs. median2.3×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration100% of spending on code S5140 with only 3 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	2,447	$4.34M
2019	2,368	$4.27M
2020	2,451	$4.13M
2021	2,157	$3.95M
2022	45,417	$3.83M
2023	47,000	$3.66M
2024incomplete	36,658	$2.87M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
S5140	Foster care, adult; per diem	100%	138,262	12,042	$27.05M
G9001	Coordinated care fee, initial rate	<1%	118	118	$6K
G9002	Coordinated care fee, maintenance rate	<1%	118	118	$152.50

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialO'NEILL, JOHN (EXECUTIVE DIRECTOR)

Same official

Other billing entities under O'NEILL, JOHN

Full network →

Provider	Location	Paid
Somerville Cambridge Elder Services	Somerville, MA	$90.18M
Bayview Hospice LLC	Bay Village, OH	$4.44M
Lakewood Senior Campus, LLC	Lakewood, OH	$2.29M
Somerville Cambridge Elder Services	Somerville, MA	$1.42M
Somerville Cambridge Elder Services	Somerville, MA	$33K
John O'neill, Licsw, PLLC	Spokane, WA	$2K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.