Agency
Criterion In-Home Health Service , LLC
Criterion In-Home Health Service , LLC was paid $5.59M by Medicaid between Apr 2018 and Nov 2024, across 2 billing codes. Its largest line is T1019, help at home with bathing, dressing and eating, billed per 15 minutes — 99% of everything it billed.
33Billing provider infoCRITERION IN-HOME HEALTH SERVICE , LLC
SAINT LOUIS, MO 63132
SAINT LOUIS, MO 63132
33aNPI1336489145assigned 02/15/2013
33bProvider typeIn Home Supportive Care Agency
28Total paid$5.59M
24GClaims31,324
24DCodes billed2
24AFirst – last monthApr 2018 – Nov 2024
Compared with peers
Next to other In Home Supportive Care Agency providers in Missouri
Rank by total paid#63 of 321
Median peer was paid$2.00M
This provider vs. median2.8×
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 Concentration99% of spending on code T1019 with only 2 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 | 446 | $18K | |
| 2019 | 2,269 | $115K | |
| 2020 | 2,088 | $114K | |
| 2021 | 4,065 | $550K | |
| 2022 | 9,902 | $1.95M | |
| 2023 | 7,705 | $1.78M | |
| 2024incomplete | 4,849 | $1.07M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1019 | Help at home with bathing, dressing and eating, billed per 15 minutesPersonal 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) | 99% | 29,353 | 1,506 | $5.51M |
| T1001 | Nursing assessment / evaluation | 1.4% | 1,971 | 594 | $80K |
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 officialBECTON, DONNA (DIRECTOR)