Is UPPER MANHATTAN MENTAL HEALTH CENTER, INC. flagged for Medicaid fraud?

UPPER MANHATTAN MENTAL HEALTH CENTER, INC. (NPI: 1053335620) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does UPPER MANHATTAN MENTAL HEALTH CENTER, INC. bill Medicaid?

UPPER MANHATTAN MENTAL HEALTH CENTER, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Counselor, Mental Health provider. Located in NEW YORK, NY.

What is NPI 1053335620?

NPI 1053335620 is the National Provider Identifier for UPPER MANHATTAN MENTAL HEALTH CENTER, INC.. They are a Counselor, Mental Health provider based in NEW YORK, NY. This NPI is registered with the CMS NPI Registry.

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UPPER MANHATTAN MENTAL HEALTH CENTER, INC.

Counselor, Mental Health·NEW YORK, NY·NPI: 1053335620Share

Compared to Counselor, Mental Health Peers

Total spending distribution among 27 providers in this specialty

P25MedianP75P90

This provider's total spending of $41.8M is at the 75th percentile among 27 Counselor, Mental Health providers.

Active Billing Period:2018-10→2024-12(75 months)

Total Paid

$41.8M

$41,846,513

Total Claims

396K

Beneficiaries

224K

1.8 claims/patient

Avg Cost/Claim

$106

Monthly Spending Trend

Yearly Spending

2018

$24K

+7280%

2019

$1.8M

+328%

2020

$7.6M

+4%

2021

$7.9M

+19%

2022

$9.3M

+3%

2023

$9.6M

-41%

2024

$5.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 22 distinct procedure codes. The top code (90834 (Psychotherapy, 45 minutes)) accounts for 35% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

90834Psychotherapy, 45 minutesSee all providers →

$14.5M

103K claims

$141.54

$63.65

2.2×

Top 5%

90834Top 5%

Psychotherapy, 45 minutes

$14.5M

103K claims · 34.7%

Your Cost: $141.54/claim|Median: $63.65

2.2× median

90832Psychotherapy, 30 minutesSee all providers →

$9.9M

95K claims

$104.03

$41.28

2.5×

Top 10%

90832Top 10%

Psychotherapy, 30 minutes

$9.9M

95K claims · 23.6%

Your Cost: $104.03/claim|Median: $41.28

2.5× median

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

$5.5M

55K claims

$100.90

$37.81

2.7×

Top 5%

99213Top 5%

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

$5.5M

55K claims · 13.3%

Your Cost: $100.90/claim|Median: $37.81

2.7× median

90847Family psychotherapy with patient, 50 minSee all providers →

$2.5M

11K claims

$222.39

$77.33

2.9×

Top 5%

90847Top 5%

Family psychotherapy with patient, 50 min

$2.5M

11K claims · 6.0%

Your Cost: $222.39/claim|Median: $77.33

2.9× median

90846Family psychotherapy without patient, 50 minSee all providers →

$1.8M

17K claims

$106.80

$76.61

1.4×

Top 25%

90846Top 25%

Family psychotherapy without patient, 50 min

$1.8M

17K claims · 4.2%

Your Cost: $106.80/claim|Median: $76.61

1.4× median

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

$1.7M

30K claims

$58.19

$47.35

1.2×

Normal range

H0005Normal range

Alcohol and/or drug services, group counseling

$1.7M

30K claims · 4.2%

Your Cost: $58.19/claim|Median: $47.35

1.2× median

90791Psychiatric diagnostic evaluationSee all providers →

$1.5M

7,319 claims

$206.13

$99.21

2.1×

Top 10%

90791Top 10%

Psychiatric diagnostic evaluation

$1.5M

7,319 claims · 3.6%

Your Cost: $206.13/claim|Median: $99.21

2.1× median

H2012Behavioral health day treatment, per hourSee all providers →

$1.4M

13K claims

$108.79

$137.86

0.8×

Normal range

H2012Normal range

Behavioral health day treatment, per hour

$1.4M

13K claims · 3.4%

Your Cost: $108.79/claim|Median: $137.86

0.8× median

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

$1.2M

22K claims

$54.54

$55.04

1.0×

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

$1.2M

22K claims · 2.8%

Your Cost: $54.54/claim|Median: $55.04

1.0× median

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

$575K

4,784 claims

$120.19

$53.41

2.3×

Top 5%

99214Top 5%

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

$575K

4,784 claims · 1.4%

Your Cost: $120.19/claim|Median: $53.41

2.3× median

99212Office/outpatient visit, low complexitySee all providers →

$514K

4,860 claims

$105.76

$25.06

4.2×

Top 5%

99212Top 5%

Office/outpatient visit, low complexity

$514K

4,860 claims · 1.2%

Your Cost: $105.76/claim|Median: $25.06

4.2× median

99051 See all providers →

$371K

28K claims

$13.39

$7.89

1.7×

Normal range

99051Normal range

$371K

28K claims · 0.9%

Your Cost: $13.39/claim|Median: $7.89

1.7× median

90853Group psychotherapySee all providers →

$142K

2,419 claims

$58.56

$25.02

2.3×

Top 25%

90853Top 25%

Group psychotherapy

$142K

2,419 claims · 0.3%

Your Cost: $58.56/claim|Median: $25.02

2.3× median

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

$57K

1,126 claims

$50.49

$74.63

0.7×

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

$57K

1,126 claims · 0.1%

Your Cost: $50.49/claim|Median: $74.63

0.7× median

99211Office/outpatient visit, minimal complexitySee all providers →

$24K

1,263 claims

$18.88

$12.93

1.5×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$24K

1,263 claims · 0.1%

Your Cost: $18.88/claim|Median: $12.93

1.5× median

H2010Comprehensive medication services, per 15 minSee all providers →

$23K

400 claims

$57.57

$62.69

0.9×

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

$23K

400 claims · 0.1%

Your Cost: $57.57/claim|Median: $62.69

0.9× median

99422Online digital E/M, 11-20 minSee all providers →

$20K

246 claims

$80.59

$17.90

4.5×

Top 5%

99422Top 5%

Online digital E/M, 11-20 min

$20K

246 claims · 0.0%

Your Cost: $80.59/claim|Median: $17.90

4.5× median

99401 See all providers →

$17K

462 claims

$36.59

$16.53

2.2×

Top 5%

99401Top 5%

$17K

462 claims · 0.0%

Your Cost: $36.59/claim|Median: $16.53

2.2× median

H0001Alcohol and/or drug assessmentSee all providers →

$8K

38 claims

$198.90

$94.22

2.1×

Top 10%

H0001Top 10%

Alcohol and/or drug assessment

$8K

38 claims · 0.0%

Your Cost: $198.90/claim|Median: $94.22

2.1× median

90882Environmental interventionSee all providers →

$4K

91 claims

$47.68

$45.05

1.1×

Normal range

90882Normal range

Environmental intervention

$4K

91 claims · 0.0%

Your Cost: $47.68/claim|Median: $45.05

1.1× median

T1023Screening to determine appropriateness of consideration for programSee all providers →

$811

17 claims

$47.68

$106.70

0.4×

Normal range

T1023Normal range

Screening to determine appropriateness of consideration for program

$811

17 claims · 0.0%

Your Cost: $47.68/claim|Median: $106.70

0.4× median

90833Psychotherapy, 30 min, add-on to E/M serviceSee all providers →

$767

15 claims

$51.14

$38.83

1.3×

Normal range

90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$767

15 claims · 0.0%

Your Cost: $51.14/claim|Median: $38.83

1.3× median

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