Agency
Somerville Cambridge Elder Services
Somerville Cambridge Elder Services was paid $90.18M by Medicaid between Jan 2018 and Nov 2024, across 19 billing codes. Its largest line is G0156, Services of home health/hospice aide in home health or hospice settings, each 15 minutes — 40% of everything it billed.
33Billing provider infoSOMERVILLE CAMBRIDGE ELDER SERVICES
SOMERVILLE, MA 02143
SOMERVILLE, MA 02143
33aNPI1508990490assigned 03/15/2007
33bProvider typeCase Management Agency
28Total paid$90.18M
24GClaims236,420
24DCodes billed19
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Case Management Agency providers in Massachusetts
Rank by total paid#33 of 139
Median peer was paid$11.53M
This provider vs. median7.8×
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.
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 | 36,750 | $16.73M | |
| 2019 | 40,707 | $17.96M | |
| 2020 | 37,655 | $15.88M | |
| 2021 | 35,670 | $15.39M | |
| 2022 | 34,740 | $14.07M | |
| 2023 | 30,348 | $7.91M | |
| 2024incomplete | 20,550 | $2.24M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0156 | Services of home health/hospice aide in home health or hospice settings, each 15 minutes | 40% | 8,335 | 3,585 | $36.47M |
| 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) | 34% | 32,885 | 7,146 | $30.64M |
| S5140 | Foster care, adult; per diem | 11% | 5,323 | 4,047 | $9.83M |
| S5130 | Homemaker services, billed per 15 minutesHomemaker service, nos; per 15 minutes | 7.5% | 50,424 | 9,364 | $6.75M |
| S5170 | Home delivered meals, including preparation; per meal | 3.8% | 92,414 | 16,734 | $3.45M |
| S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | 1.4% | 9,707 | 1,632 | $1.23M |
| S5120 | Chore services; per 15 minutes | <1% | 3,200 | 1,036 | $438K |
| T2003 | Non-emergency transportation, per tripNon-emergency transportation; encounter/trip | <1% | 6,778 | 1,925 | $361K |
| S5175 | Laundry service, external, professional; per order | <1% | 11,380 | 2,505 | $289K |
| S5161 | Emergency response system; service fee, per month (excludes installation and testing) | <1% | 8,568 | 8,566 | $208K |
| S5165 | Home modifications; per service | <1% | 1,108 | 1,073 | $206K |
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | <1% | 1,162 | 416 | $104K |
7 more codes
| H0046 | Mental health services, not otherwise specified | <1% | 2,759 | $47K |
| S5125 | Attendant care at home, billed per 15 minutes | <1% | 26 | $44K |
| S0280 | Medical home program, comprehensive care coordination and planning, initial plan | <1% | 301 | $40K |
| S5121 | Chore services; per diem | <1% | 998 | $37K |
| G9001 | Coordinated care fee, initial rate | <1% | 507 | $30K |
| T1020 | Help at home with daily living, billed per day | <1% | 38 | $2K |
| G9002 | Coordinated care fee, maintenance rate | <1% | 507 | $385.24 |
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)
| Provider | Location | Paid |
|---|---|---|
| Somerville Cambridge Elder Services | Somerville, MA | $27.05M |
| 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.