Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

RESTORATIVE MANAGEMENT CORP

Substance Abuse Rehabilitation Facility·MIDDLETOWN, NY·NPI: 1043385578Share

Compared to Substance Abuse Rehabilitation Facility Peers

Total spending distribution among 20 providers in this specialty

P25MedianP75P90

This provider's total spending of $18.5M is at the 25th percentile among 20 Substance Abuse Rehabilitation Facility providers.

Active Billing Period:2019-012024-12(69 months)

Total Paid

$18.5M

$18,470,428

Total Claims

233K

Beneficiaries

58K

4.0 claims/patient

Avg Cost/Claim

$79

Monthly Spending Trend

Yearly Spending

2019
$885K
+292%
2020
$3.5M
+6%
2021
$3.7M
+7%
2022
$3.9M
+3%
2023
$4.0M
-38%
2024
$2.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 10 distinct procedure codes. The top code (G0396 (Alcohol/substance abuse structured assessment, 15-30 minutes)) accounts for 39% of total spending.

G0396Top 25%

Alcohol/substance abuse structured assessment, 15-30 minutes

$7.3M

64K claims · 39.4%

Your Cost: $114.15/claim|Median: $40.58
2.8× median
H0005Top 25%

Alcohol and/or drug services, group counseling

$7.0M

119K claims · 37.8%

Your Cost: $58.67/claim|Median: $47.35
1.2× median
S9480Normal range

Intensive outpatient psychiatric services, per diem

$918K

8,276 claims · 5.0%

Your Cost: $110.93/claim|Median: $135.70
0.8× median
H0002Top 5%

Behavioral health screening

$900K

4,716 claims · 4.9%

Your Cost: $190.78/claim|Median: $38.77
4.9× median
H0038Normal range

Self-help/peer services, per 15 minutes

$766K

17K claims · 4.1%

Your Cost: $44.57/claim|Median: $55.04
0.8× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$674K

13K claims · 3.6%

Your Cost: $50.76/claim|Median: $74.63
0.7× median
G0397Normal range

$439K

2,893 claims · 2.4%

Your Cost: $151.71/claim|Median: $142.31
1.1× median
99214Top 5%

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

$295K

2,005 claims · 1.6%

Your Cost: $147.06/claim|Median: $53.41
2.8× median
99213Top 5%

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

$219K

1,476 claims · 1.2%

Your Cost: $148.67/claim|Median: $37.81
3.9× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$5K

34 claims · 0.0%

Your Cost: $137.58/claim|Median: $84.03
1.6× median