PRESBYTERIAN RESIDENTIAL COMMUNITY, INC.
NPI: 1912008608
· NEW HARTFORD, NY 13413
· Home Health Agency
· NPI assigned 09/26/2006
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
96% of spending on code T1019 with only 2 total codes billed. Highly concentrated billing profile.
$2.08M
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
3,792 |
$202K |
| 2020 |
8,841 |
$464K |
| 2021 |
6,550 |
$368K |
| 2022 |
5,111 |
$288K |
| 2023 |
4,756 |
$341K |
| 2024 |
4,984 |
$414K |
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) |
32,206 |
2,515 |
$2.00M |
| S5130 |
Homemaker service, nos; per 15 minutes |
1,828 |
415 |
$75K |