CASA MIA HOME CARE, LLC.
NPI: 1225505514
· MCALLEN, TX 78504
· Developmentally Disabled Services Day Training Agency
· NPI assigned 10/25/2018
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
99% of spending on code S5125 with only 3 total codes billed. Highly concentrated billing profile.
$8.53M
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
16,909 |
$728K |
| 2021 |
50,038 |
$2.22M |
| 2022 |
48,847 |
$2.53M |
| 2023 |
33,013 |
$1.62M |
| 2024 |
26,282 |
$1.43M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5125 |
Attendant care services; per 15 minutes |
170,840 |
6,179 |
$8.42M |
| T1019 |
Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) |
3,130 |
122 |
$73K |
| T1005 |
Respite care services, up to 15 minutes |
1,119 |
52 |
$37K |