Is TRI-COUNTY MENTAL HEALTH SERVICES, INC. flagged for Medicaid fraud?

TRI-COUNTY MENTAL HEALTH SERVICES, INC. (NPI: 1003359977) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does TRI-COUNTY MENTAL HEALTH SERVICES, INC. bill Medicaid?

TRI-COUNTY MENTAL HEALTH SERVICES, INC. received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in KANSAS CITY, MO.

What is NPI 1003359977?

NPI 1003359977 is the National Provider Identifier for TRI-COUNTY MENTAL HEALTH SERVICES, INC.. They are a Community/Behavioral Health provider based in KANSAS CITY, MO. This NPI is registered with the CMS NPI Registry.

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TRI-COUNTY MENTAL HEALTH SERVICES, INC.

Community/Behavioral Health·KANSAS CITY, MO·NPI: 1003359977Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $76.2M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$76.2M

$76,196,378

Total Claims

810K

Beneficiaries

248K

3.3 claims/patient

Avg Cost/Claim

$94

Monthly Spending Trend

Yearly Spending

2018

$10.4M

+3%

2019

$10.7M

+2%

2020

$10.9M

-6%

2021

$10.3M

+8%

2022

$11.1M

+15%

2023

$12.7M

-21%

2024

$10.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 17 distinct procedure codes. The top code (T1040 (Medicaid certified CCBHC services)) accounts for 99% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1040Medicaid certified CCBHC servicesSee all providers →

$75.8M

386K claims

$196.56

$130.29

1.5×

Normal range

T1040Normal range

Medicaid certified CCBHC services

$75.8M

386K claims · 99.5%

Your Cost: $196.56/claim|Median: $130.29

1.5× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$183K

31K claims

$6.00

$37.81

0.2×

Normal range

99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$183K

31K claims · 0.2%

Your Cost: $6.00/claim|Median: $37.81

0.2× median

90834Psychotherapy, 45 minutesSee all providers →

$95K

16K claims

$5.81

$63.65

0.1×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$95K

16K claims · 0.1%

Your Cost: $5.81/claim|Median: $63.65

0.1× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$59K

4,786 claims

$12.30

$53.41

0.2×

Normal range

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$59K

4,786 claims · 0.1%

Your Cost: $12.30/claim|Median: $53.41

0.2× median

90791Psychiatric diagnostic evaluationSee all providers →

$28K

1,524 claims

$18.63

$99.21

0.2×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$28K

1,524 claims · 0.0%

Your Cost: $18.63/claim|Median: $99.21

0.2× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$21K

617 claims

$34.37

$108.91

0.3×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$21K

617 claims · 0.0%

Your Cost: $34.37/claim|Median: $108.91

0.3× median

H0025Behavioral health prevention education, per sessionSee all providers →

39K claims

$0.00

$36.25

—

Normal range

H0025Normal range

Behavioral health prevention education, per session

39K claims · 0.0%

Your Cost: $0.00/claim|Median: $36.25

H2015Comprehensive community support services, per 15 minSee all providers →

3,083 claims

$0.00

$96.24

—

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

3,083 claims · 0.0%

Your Cost: $0.00/claim|Median: $96.24

H0005Alcohol and/or drug services, group counselingSee all providers →

16K claims

$0.00

$47.35

—

Normal range

H0005Normal range

Alcohol and/or drug services, group counseling

16K claims · 0.0%

Your Cost: $0.00/claim|Median: $47.35

H0004Behavioral health counseling & therapy, per 15 minSee all providers →

10K claims

$0.00

$74.63

—

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

10K claims · 0.0%

Your Cost: $0.00/claim|Median: $74.63

H0037Community psychiatric supportive treatment program, per diemSee all providers →

19K claims

$0.00

$225.50

—

Normal range

H0037Normal range

Community psychiatric supportive treatment program, per diem

19K claims · 0.0%

Your Cost: $0.00/claim|Median: $225.50

H2010Comprehensive medication services, per 15 minSee all providers →

6,855 claims

$0.00

$62.69

—

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

6,855 claims · 0.0%

Your Cost: $0.00/claim|Median: $62.69

H0038Self-help/peer services, per 15 minutesSee all providers →

5,312 claims

$0.00

$55.04

—

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

5,312 claims · 0.0%

Your Cost: $0.00/claim|Median: $55.04

H0032Mental health service plan developmentSee all providers →

4,735 claims

$0.00

$80.64

—

Normal range

H0032Normal range

Mental health service plan development

4,735 claims · 0.0%

Your Cost: $0.00/claim|Median: $80.64

H0036Community psychiatric supportive treatment, per 15 minSee all providers →

154K claims

$0.00

$76.05

—

Normal range

H0036Normal range

Community psychiatric supportive treatment, per 15 min

154K claims · 0.0%

Your Cost: $0.00/claim|Median: $76.05

H0002Behavioral health screeningSee all providers →

4,490 claims

$0.00

$38.77

—

Normal range

H0002Normal range

Behavioral health screening

4,490 claims · 0.0%

Your Cost: $0.00/claim|Median: $38.77

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

107K claims

$0.00

$91.63

—

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

107K claims · 0.0%

Your Cost: $0.00/claim|Median: $91.63

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