Is BRIGHTER HEIGHTS MAINE, LLC flagged for Medicaid fraud?

BRIGHTER HEIGHTS MAINE, LLC (NPI: 1013223361) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does BRIGHTER HEIGHTS MAINE, LLC bill Medicaid?

BRIGHTER HEIGHTS MAINE, LLC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in YARMOUTH, ME.

What is NPI 1013223361?

NPI 1013223361 is the National Provider Identifier for BRIGHTER HEIGHTS MAINE, LLC. They are a Community/Behavioral Health provider based in YARMOUTH, ME. This NPI is registered with the CMS NPI Registry.

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BRIGHTER HEIGHTS MAINE, LLC

Community/Behavioral Health·YARMOUTH, ME·NPI: 1013223361Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $27.8M is at the 25th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$27.8M

$27,842,117

Total Claims

144K

Beneficiaries

26K

5.5 claims/patient

Avg Cost/Claim

$193

Monthly Spending Trend

Yearly Spending

2018

$2.6M

+1%

2019

$2.7M

-23%

2020

$2.1M

+108%

2021

$4.3M

+2%

2022

$4.4M

+39%

2023

$6.1M

-6%

2024

$5.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (H2021 (Community-based wrap-around services, per 15 min)) accounts for 39% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2021Community-based wrap-around services, per 15 minSee all providers →

$10.9M

60K claims

$182.38

$169.11

1.1×

Normal range

H2021Normal range

Community-based wrap-around services, per 15 min

$10.9M

60K claims · 39.1%

Your Cost: $182.38/claim|Median: $169.11

1.1× median

T2016Habilitation, residential, waiver; per diemSee all providers →

$8.5M

18K claims

$482.97

$331.94

1.5×

Normal range

T2016Normal range

Habilitation, residential, waiver; per diem

$8.5M

18K claims · 30.6%

Your Cost: $482.97/claim|Median: $331.94

1.5× median

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

$2.2M

22K claims

$100.25

$91.63

1.1×

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

$2.2M

22K claims · 8.0%

Your Cost: $100.25/claim|Median: $91.63

1.1× median

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

$988K

12K claims

$85.33

$74.63

1.1×

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

$988K

12K claims · 3.5%

Your Cost: $85.33/claim|Median: $74.63

1.1× median

H2012Behavioral health day treatment, per hourSee all providers →

$969K

5,142 claims

$188.52

$137.86

1.4×

Top 25%

H2012Top 25%

Behavioral health day treatment, per hour

$969K

5,142 claims · 3.5%

Your Cost: $188.52/claim|Median: $137.86

1.4× median

T2022Case management, per monthSee all providers →

$863K

2,692 claims

$320.49

$202.77

1.6×

Top 25%

T2022Top 25%

Case management, per month

$863K

2,692 claims · 3.1%

Your Cost: $320.49/claim|Median: $202.77

1.6× median

H2010Comprehensive medication services, per 15 minSee all providers →

$794K

5,209 claims

$152.45

$62.69

2.4×

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

$794K

5,209 claims · 2.9%

Your Cost: $152.45/claim|Median: $62.69

2.4× median

G9012Other specified case management service, per 15 minutesSee all providers →

$762K

11K claims

$71.60

$137.85

0.5×

Normal range

G9012Normal range

Other specified case management service, per 15 minutes

$762K

11K claims · 2.7%

Your Cost: $71.60/claim|Median: $137.85

0.5× median

H0047Alcohol and/or drug abuse, not otherwise specifiedSee all providers →

$701K

2,738 claims

$256.12

$81.37

3.1×

Top 25%

H0047Top 25%

Alcohol and/or drug abuse, not otherwise specified

$701K

2,738 claims · 2.5%

Your Cost: $256.12/claim|Median: $81.37

3.1× median

99408 See all providers →

$686K

2,763 claims

$248.26

$9.32

26.6×

Top 5%

99408Top 5%

$686K

2,763 claims · 2.5%

Your Cost: $248.26/claim|Median: $9.32

26.6× median

G9007 See all providers →

$226K

2,379 claims

$94.98

$43.44

2.2×

Top 25%

G9007Top 25%

$226K

2,379 claims · 0.8%

Your Cost: $94.98/claim|Median: $43.44

2.2× median

H2000Comprehensive multidisciplinary evaluationSee all providers →

$190K

1,040 claims

$182.69

$114.71

1.6×

Top 25%

H2000Top 25%

Comprehensive multidisciplinary evaluation

$190K

1,040 claims · 0.7%

Your Cost: $182.69/claim|Median: $114.71

1.6× median

T1012Alcohol/drug services, skills developmentSee all providers →

$21K

77 claims

$269.42

$40.78

6.6×

Top 10%

T1012Top 10%

Alcohol/drug services, skills development

$21K

77 claims · 0.1%

Your Cost: $269.42/claim|Median: $40.78

6.6× median

Q3014Telehealth originating site facility feeSee all providers →

$1K

93 claims

$15.35

$15.37

1.0×

Normal range

Q3014Normal range

Telehealth originating site facility fee

$1K

93 claims · 0.0%

Your Cost: $15.35/claim|Median: $15.37

1.0× median

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