G.E.M. HEALTH CARE AGENCY
NPI: 1285794164
· FREEPORT, NY 11520
· Home Health Agency
· NPI assigned 12/11/2006
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
99% of spending on code T1019 with only 2 total codes billed. Highly concentrated billing profile.
$12.51M
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
11,987 |
$1.76M |
| 2019 |
13,570 |
$2.22M |
| 2020 |
7,591 |
$1.31M |
| 2021 |
8,474 |
$1.66M |
| 2022 |
7,913 |
$1.73M |
| 2023 |
7,619 |
$1.80M |
| 2024 |
7,504 |
$2.04M |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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) |
63,470 |
2,903 |
$12.35M |
| T1020 |
Personal care services, per diem, 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) |
1,188 |
60 |
$162K |