County of Sacramento
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $202.49 per claim for H2010 (Comprehensive medication services, per 15 min), which is 3.2× the national median of $62.69.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 28 procedure codes: S9484 at 10.3× median, 90837 at 4.6× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
Unusually High Spending
Unusually High Spending means this provider's total Medicaid payments are significantly above the median for their specialty. This doesn't necessarily indicate fraud — high volume practices and those serving complex populations may legitimately bill more.
High Cost Per Claim
High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $202.49 per claim for H2010 (Comprehensive medication services, per 15 min) — 3.2× the national median of $62.69.
Bills $2,559.45 per claim for S9484 (Crisis intervention mental health services, per hour) — 10.3× the national median of $249.51.
Bills $392.79 per claim for 90837 (Psychotherapy, 60 minutes) — 4.6× the national median of $85.66.
Billing in the top 1% nationally for 7 procedure codes: 90837, 99215, 99214.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$903.1M
$903,144,308
Total Claims
4.3M
Beneficiaries
1.9M
2.3 claims/patient
Avg Cost/Claim
$209
#41 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
County of Sacramento is a Clinic/Center Adult Mental Health provider based in Sacramento, CA. From the 2018–2024 period, this provider received $903.1M in Medicaid payments across 4.3M claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $903.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 112,893 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 25% of total spending.
$221.9M
1.1M claims
$202.82
$96.24
Comprehensive community support services, per 15 min
$221.9M
1.1M claims · 24.6%
$154.9M
739K claims
$209.54
$91.63
Psychosocial rehabilitation services, per 15 min
$154.9M
739K claims · 17.1%
$121.1M
1.2M claims
$102.43
$69.56
Targeted case management, per 15 min
$121.1M
1.2M claims · 13.4%
$118.7M
586K claims
$202.49
$62.69
Comprehensive medication services, per 15 min
$118.7M
586K claims · 13.1%
$66.8M
76K claims
$877.38
$841.93
Psychiatric health facility service, per diem
$66.8M
76K claims · 7.4%
$34.3M
64K claims
$533.64
$467.51
Behavioral health; short-term residential, per diem
$34.3M
64K claims · 3.8%
$31.8M
12K claims
$2,559.45
$249.51
Crisis intervention mental health services, per hour
$31.8M
12K claims · 3.5%
$29.8M
187K claims
$159.55
$80.64
Mental health service plan development
$29.8M
187K claims · 3.3%
Psychotherapy, 60 minutes
$26.0M
66K claims · 2.9%
$17.2M
42K claims
$408.29
$72.96
Prolonged office/outpatient E/M, each additional 15 min
$17.2M
42K claims · 1.9%
$15.0M
55K claims
$271.52
$84.12
Therapeutic behavioral services, per 15 min
$15.0M
55K claims · 1.7%
$9.9M
10K claims
$984.74
$74.09
Office/outpatient visit, high complexity
$9.9M
10K claims · 1.1%
$8.3M
15K claims
$559.84
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$8.3M
15K claims · 0.9%
$6.2M
13K claims
$490.24
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$6.2M
13K claims · 0.7%
$5.5M
18K claims
$300.36
$96.18
Mental health assessment by non-physician
$5.5M
18K claims · 0.6%
$5.4M
37K claims
$144.29
$56.90
Medication training and management, per 15 min
$5.4M
37K claims · 0.6%
$4.8M
5K claims
$1,050.68
$259.38
Supported employment, waiver, per diem
$4.8M
5K claims · 0.5%
Psychiatric diagnostic evaluation
$3.9M
28K claims · 0.4%
$3.7M
18K claims
$203.46
$55.04
Self-help/peer services, per 15 minutes
$3.7M
18K claims · 0.4%
Psychotherapy, 45 minutes
$3.3M
11K claims · 0.4%
Day habilitation, waiver; per 15 min
$2.5M
5K claims · 0.3%
$1.9M
10K claims
$194.36
$215.80
Crisis intervention service, per 15 minutes
$1.9M
10K claims · 0.2%
$1.9M
6K claims
$333.25
$108.91
Psychiatric diagnostic evaluation with medical services
$1.9M
6K claims · 0.2%
$1.7M
7K claims · 0.2%
$1.6M
7K claims
$215.44
$31.37
Oral medication administration, direct observation
$1.6M
7K claims · 0.2%
Psychotherapy, 30 minutes
$1.2M
6K claims · 0.1%
$767K
2K claims · 0.1%
$643K
2K claims
$344.74
$77.33
Family psychotherapy with patient, 50 min
$643K
2K claims · 0.1%
$451K
1K claims · 0.0%
$380K
2K claims
$233.24
$25.06
Office/outpatient visit, low complexity
$380K
2K claims · 0.0%
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$1.73B
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$1.40B
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$1.34B
Los Angeles County Department of Public Health
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$1.13B
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