Agency
Quality Care Management, PLLC
Quality Care Management, PLLC was paid $2.79M by Medicaid between Jan 2018 and Nov 2024, across 1 billing code. Its largest line is G9002, Coordinated care fee, maintenance rate — 100% of everything it billed.
33Billing provider infoQUALITY CARE MANAGEMENT, PLLC
ELKINS, WV 26241
ELKINS, WV 26241
33aNPI1912172008assigned 04/29/2008
33bProvider typeCase Management Agency
28Total paid$2.79M
24GClaims22,211
24DCodes billed1
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Case Management Agency providers in West Virginia
Rank by total paid#12 of 72
Median peer was paid$365K
This provider vs. median7.6×
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 Concentration100% of spending on code G9002 with only 1 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 | 2,779 | $197K | |
| 2019 | 2,658 | $212K | |
| 2020 | 2,735 | $218K | |
| 2021 | 2,932 | $300K | |
| 2022 | 3,304 | $445K | |
| 2023 | 3,977 | $723K | |
| 2024incomplete | 3,826 | $691K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G9002 | Coordinated care fee, maintenance rate | 100% | 22,211 | 22,105 | $2.79M |
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 officialSILVESTER, MARSHA (OWNER)