Is LUTHERAN SOCIAL SERVICES OF ILLINOIS flagged for Medicaid fraud?

LUTHERAN SOCIAL SERVICES OF ILLINOIS (NPI: 1063637684) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does LUTHERAN SOCIAL SERVICES OF ILLINOIS bill Medicaid?

LUTHERAN SOCIAL SERVICES OF ILLINOIS received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinic/Center, Mental Health (Including Community Mental Health Center) provider. Located in CHICAGO, IL.

What is NPI 1063637684?

NPI 1063637684 is the National Provider Identifier for LUTHERAN SOCIAL SERVICES OF ILLINOIS. They are a Clinic/Center, Mental Health (Including Community Mental Health Center) provider based in CHICAGO, IL. This NPI is registered with the CMS NPI Registry.

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LUTHERAN SOCIAL SERVICES OF ILLINOIS

Clinic/Center, Mental Health (Including Community Mental Health Center)·CHICAGO, IL·NPI: 1063637684Share

Compared to Clinic/Center, Mental Health (Including Community Mental Health Center) Peers

Total spending distribution among 44 providers in this specialty

P25MedianP75P90

This provider's total spending of $51.2M is at the 75th percentile among 44 Clinic/Center, Mental Health (Including Community Mental Health Center) providers.

Active Billing Period:2018-01→2024-09(81 months)

Total Paid

$51.2M

$51,208,730

Total Claims

370K

Beneficiaries

150K

2.5 claims/patient

Avg Cost/Claim

$139

Monthly Spending Trend

Yearly Spending

2018

$5.6M

+63%

2019

$9.2M

-8%

2020

$8.4M

-24%

2021

$6.4M

+7%

2022

$6.8M

+13%

2023

$7.7M

-8%

2024

$7.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 17 distinct procedure codes. The top code (H2011 (Crisis intervention service, per 15 minutes)) accounts for 39% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2011Crisis intervention service, per 15 minutesSee all providers →

$20.2M

86K claims

$234.47

$215.80

1.1×

Normal range

H2011Normal range

Crisis intervention service, per 15 minutes

$20.2M

86K claims · 39.4%

Your Cost: $234.47/claim|Median: $215.80

1.1× median

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

$8.0M

80K claims

$99.39

$74.63

1.3×

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

$8.0M

80K claims · 15.6%

Your Cost: $99.39/claim|Median: $74.63

1.3× median

H2000Comprehensive multidisciplinary evaluationSee all providers →

$6.7M

79K claims

$84.42

$114.71

0.7×

Normal range

H2000Normal range

Comprehensive multidisciplinary evaluation

$6.7M

79K claims · 13.1%

Your Cost: $84.42/claim|Median: $114.71

0.7× median

H2015Comprehensive community support services, per 15 minSee all providers →

$6.4M

48K claims

$132.64

$96.24

1.4×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$6.4M

48K claims · 12.4%

Your Cost: $132.64/claim|Median: $96.24

1.4× median

H2016Comprehensive community support services, per 15 minSee all providers →

$5.6M

36K claims

$157.38

$321.53

0.5×

Normal range

H2016Normal range

Comprehensive community support services, per 15 min

$5.6M

36K claims · 11.0%

Your Cost: $157.38/claim|Median: $321.53

0.5× median

S9484Crisis intervention mental health services, per hourSee all providers →

$2.9M

11K claims

$274.22

$249.51

1.1×

Normal range

S9484Normal range

Crisis intervention mental health services, per hour

$2.9M

11K claims · 5.7%

Your Cost: $274.22/claim|Median: $249.51

1.1× median

T1016Case management, each 15 minSee all providers →

$1.1M

25K claims

$42.71

$49.62

0.9×

Normal range

T1016Normal range

Case management, each 15 min

$1.1M

25K claims · 2.1%

Your Cost: $42.71/claim|Median: $49.62

0.9× median

T1023Screening to determine appropriateness of consideration for programSee all providers →

$113K

326 claims

$346.04

$106.70

3.2×

Top 10%

T1023Top 10%

Screening to determine appropriateness of consideration for program

$113K

326 claims · 0.2%

Your Cost: $346.04/claim|Median: $106.70

3.2× median

G9007 See all providers →

$76K

235 claims

$325.00

$43.44

7.5×

Top 5%

G9007Top 5%

$76K

235 claims · 0.1%

Your Cost: $325.00/claim|Median: $43.44

7.5× median

H0031Mental health assessment by non-physicianSee all providers →

$69K

783 claims

$87.56

$96.18

0.9×

Normal range

H0031Normal range

Mental health assessment by non-physician

$69K

783 claims · 0.1%

Your Cost: $87.56/claim|Median: $96.18

0.9× median

H2010Comprehensive medication services, per 15 minSee all providers →

$49K

930 claims

$52.45

$62.69

0.8×

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

$49K

930 claims · 0.1%

Your Cost: $52.45/claim|Median: $62.69

0.8× median

H0032Mental health service plan developmentSee all providers →

$33K

481 claims

$68.40

$80.64

0.8×

Normal range

H0032Normal range

Mental health service plan development

$33K

481 claims · 0.1%

Your Cost: $68.40/claim|Median: $80.64

0.8× median

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

$19K

586 claims

$31.94

$91.63

0.3×

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

$19K

586 claims · 0.0%

Your Cost: $31.94/claim|Median: $91.63

0.3× median

T1502Administration of oral, intramuscular, or subcutaneous medicationSee all providers →

$9K

638 claims

$14.55

$7.86

1.9×

Normal range

T1502Normal range

Administration of oral, intramuscular, or subcutaneous medication

$9K

638 claims · 0.0%

Your Cost: $14.55/claim|Median: $7.86

1.9× median

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

$7K

281 claims

$26.54

$37.81

0.7×

Normal range

99213Normal range

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

$7K

281 claims · 0.0%

Your Cost: $26.54/claim|Median: $37.81

0.7× median

H0002Behavioral health screeningSee all providers →

$2K

49 claims

$42.49

$38.77

1.1×

Normal range

H0002Normal range

Behavioral health screening

$2K

49 claims · 0.0%

Your Cost: $42.49/claim|Median: $38.77

1.1× median

99212Office/outpatient visit, low complexitySee all providers →

$615

31 claims

$19.84

$25.06

0.8×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$615

31 claims · 0.0%

Your Cost: $19.84/claim|Median: $25.06

0.8× median

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$195.1M

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