Is SBH EL PASO, LLC flagged for Medicaid fraud?

SBH EL PASO, LLC (NPI: 1053652438) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does SBH EL PASO, LLC bill Medicaid?

SBH EL PASO, LLC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Psychiatric Hospital provider. Located in ESPANOLA, NM.

What is NPI 1053652438?

NPI 1053652438 is the National Provider Identifier for SBH EL PASO, LLC. They are a Psychiatric Hospital provider based in ESPANOLA, NM. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

SBH EL PASO, LLC

Psychiatric Hospital·ESPANOLA, NM·NPI: 1053652438Share

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

Total Paid

$42.3M

$42,298,931

Total Claims

151K

Beneficiaries

30K

5.0 claims/patient

Avg Cost/Claim

$280

Monthly Spending Trend

Yearly Spending

2018

$210K

+888%

2019

$2.1M

+58%

2020

$3.3M

+10%

2021

$3.6M

+134%

2022

$8.4M

+33%

2023

$11.3M

+19%

2024

$13.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (S0201 (Partial hospitalization services, per diem)) accounts for 59% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

S0201Partial hospitalization services, per diemSee all providers →

$24.9M

27K claims

$937.76

$445.16

2.1×

Top 10%

S0201Top 10%

Partial hospitalization services, per diem

$24.9M

27K claims · 58.9%

Your Cost: $937.76/claim|Median: $445.16

2.1× median

H0039Assertive community treatment, per diemSee all providers →

$13.9M

68K claims

$205.13

$132.62

1.5×

Normal range

H0039Normal range

Assertive community treatment, per diem

$13.9M

68K claims · 33.0%

Your Cost: $205.13/claim|Median: $132.62

1.5× median

99232Subsequent hospital care, per day, moderate complexitySee all providers →

$1.2M

19K claims

$66.82

$23.99

2.8×

Top 5%

99232Top 5%

Subsequent hospital care, per day, moderate complexity

$1.2M

19K claims · 2.9%

Your Cost: $66.82/claim|Median: $23.99

2.8× median

99231Subsequent hospital care, per day, low complexitySee all providers →

$724K

23K claims

$31.79

$16.77

1.9×

Top 25%

99231Top 25%

Subsequent hospital care, per day, low complexity

$724K

23K claims · 1.7%

Your Cost: $31.79/claim|Median: $16.77

1.9× median

99233Subsequent hospital care, per day, high complexitySee all providers →

$390K

4,053 claims

$96.34

$35.30

2.7×

Top 5%

99233Top 5%

Subsequent hospital care, per day, high complexity

$390K

4,053 claims · 0.9%

Your Cost: $96.34/claim|Median: $35.30

2.7× median

90791Psychiatric diagnostic evaluationSee all providers →

$389K

3,622 claims

$107.28

$99.21

1.1×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$389K

3,622 claims · 0.9%

Your Cost: $107.28/claim|Median: $99.21

1.1× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$281K

2,390 claims

$117.75

$108.91

1.1×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$281K

2,390 claims · 0.7%

Your Cost: $117.75/claim|Median: $108.91

1.1× median

99238Hospital discharge day management, 30 minutes or lessSee all providers →

$242K

3,872 claims

$62.58

$37.22

1.7×

Top 10%

99238Top 10%

Hospital discharge day management, 30 minutes or less

$242K

3,872 claims · 0.6%

Your Cost: $62.58/claim|Median: $37.22

1.7× median

99239Hospital discharge day management, more than 30 minutesSee all providers →

$60K

632 claims

$94.85

$43.85

2.2×

Top 10%

99239Top 10%

Hospital discharge day management, more than 30 minutes

$60K

632 claims · 0.1%

Your Cost: $94.85/claim|Median: $43.85

2.2× median

H0035Mental health partial hospitalization, treatment, per hourSee all providers →

$45K

200 claims

$223.65

$148.53

1.5×

Normal range

H0035Normal range

Mental health partial hospitalization, treatment, per hour

$45K

200 claims · 0.1%

Your Cost: $223.65/claim|Median: $148.53

1.5× median

H0032Mental health service plan developmentSee all providers →

$31K

208 claims

$150.00

$80.64

1.9×

Top 25%

H0032Top 25%

Mental health service plan development

$31K

208 claims · 0.1%

Your Cost: $150.00/claim|Median: $80.64

1.9× median

99401 See all providers →

$10K

119 claims

$80.71

$16.53

4.9×

Top 1%

99401Top 1%

$10K

119 claims · 0.0%

Your Cost: $80.71/claim|Median: $16.53

4.9× median

99221Initial hospital care, straightforward/lowSee all providers →

$8K

168 claims

$49.54

$39.96

1.2×

Normal range

99221Normal range

Initial hospital care, straightforward/low

$8K

168 claims · 0.0%

Your Cost: $49.54/claim|Median: $39.96

1.2× median

99222Initial hospital care, per day, moderate complexitySee all providers →

$6K

76 claims

$79.26

$51.25

1.5×

Top 25%

99222Top 25%

Initial hospital care, per day, moderate complexity

$6K

76 claims · 0.0%

Your Cost: $79.26/claim|Median: $51.25

1.5× median

90837Psychotherapy, 60 minutesSee all providers →

$3K

39 claims

$76.31

$85.66

0.9×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$3K

39 claims · 0.0%

Your Cost: $76.31/claim|Median: $85.66

0.9× median

Other Top Providers in New Mexico

View all →

Ambercare Home Health Care Corporation

Home Health

$518.1M

Unm Hospital

General Acute Care Hospital

$463.3M

Presbyterian Healthcare Services

Emergency Medicine

$345.5M

Presbyterian Healthcare Services

Surgery

$240.2M

DHHS PHS Naihs Shiprock Hospital

General Acute Care Hospital

$190.6M

Similar Providers

Other top providers in Psychiatric Hospital

Bowen Health INC

Warsaw, IN

$509.3M

Uofl Health-louisville INC

Louisville, KY

$283.2M

Riverside Hospital INC

Newport News, VA

$136.8M

← All providers All providers in New Mexico →How we detect fraud →