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

Trillium Family Services Inc.

Residential Treatment Facility Emotionally Disturbed Children·Portland, OR·NPI: 1093873382SharePrint Report
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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:

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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.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

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Bills $1,844.57 per claim for H0017 — 3.9× the national median of $470.95.

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Bills $1,308.81 per claim for H0019 (Behavioral health; residential, per diem) — 3.7× the national median of $357.16.

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Bills $2,740.67 per claim for H2013 (Psychiatric health facility service, per diem) — 3.3× the national median of $841.93.

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Billing above the 90th percentile for 9 procedure codes simultaneously.

This is a statistical summary, not an accusation. See our methodology.

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

Total Paid

$154.5M

$154,478,558

Total Claims

188K

Beneficiaries

46K

4.1 claims/patient

Avg Cost/Claim

$821

#692 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Trillium Family Services Inc. is a Residential Treatment Facility Emotionally Disturbed Children provider based in Portland, OR. From the 2018–2024 period, this provider received $154.5M in Medicaid payments across 188K claims.

Why This Matters

This provider received $154.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 19,309 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 80% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$15.1M
+23%
2019
$18.6M
+2%
2020
$18.9M
+14%
2021
$21.6M
+15%
2022
$24.8M
+14%
2023
$28.4M
-4%
2024
$27.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 21 distinct procedure codes. The top code (H0017) accounts for 47% of total spending.

H0017Top 25%

$72.9M

40K claims · 47.2%

Your Cost: $1,844.57/claim|Median: $470.95
3.9× median
H0019Top 25%

Behavioral health; residential, per diem

$47.4M

36K claims · 30.7%

Your Cost: $1,308.81/claim|Median: $357.16
3.7× median
H0037Top 25%

Community psychiatric supportive treatment program, per diem

$17.8M

28K claims · 11.5%

Your Cost: $638.85/claim|Median: $225.50
2.8× median
H0004Top 25%

Behavioral health counseling & therapy, per 15 min

$8.2M

66K claims · 5.3%

Your Cost: $122.74/claim|Median: $74.63
1.6× median
H2013Top 25%

Psychiatric health facility service, per diem

$6.5M

2K claims · 4.2%

Your Cost: $2,740.67/claim|Median: $841.93
3.3× median
H2014Normal range

Skills training & development, per 15 min

$525K

6K claims · 0.3%

Your Cost: $81.07/claim|Median: $83.88
1.0× median
90837Top 5%

Psychotherapy, 60 minutes

$355K

2K claims · 0.2%

Your Cost: $163.13/claim|Median: $85.66
1.9× median
90834Top 10%

Psychotherapy, 45 minutes

$194K

1K claims · 0.1%

Your Cost: $133.80/claim|Median: $63.65
2.1× median
99214Top 5%

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

$183K

1K claims · 0.1%

Your Cost: $132.99/claim|Median: $53.41
2.5× median
90847Top 10%

Family psychotherapy with patient, 50 min

$159K

913 claims · 0.1%

Your Cost: $174.28/claim|Median: $77.33
2.3× median
90832Top 10%

Psychotherapy, 30 minutes

$139K

1K claims · 0.1%

Your Cost: $102.09/claim|Median: $41.28
2.5× median
99213Top 25%

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

$56K

890 claims · 0.0%

Your Cost: $63.31/claim|Median: $37.81
1.7× median
H2012Top 5%

Behavioral health day treatment, per hour

$44K

106 claims · 0.0%

Your Cost: $411.10/claim|Median: $137.86
3.0× median
90887Top 25%

Interpretation/explanation of results

$34K

428 claims · 0.0%

Your Cost: $79.71/claim|Median: $47.55
1.7× median
90792Top 10%

Psychiatric diagnostic evaluation with medical services

$32K

109 claims · 0.0%

Your Cost: $293.15/claim|Median: $108.91
2.7× median
H2021Normal range

Community-based wrap-around services, per 15 min

$24K

188 claims · 0.0%

Your Cost: $129.00/claim|Median: $169.11
0.8× median
90882Top 5%

Environmental intervention

$17K

164 claims · 0.0%

Your Cost: $105.50/claim|Median: $45.05
2.3× median
90853Top 25%

Group psychotherapy

$4K

68 claims · 0.0%

Your Cost: $54.95/claim|Median: $25.02
2.2× median
T1016Normal range

Case management, each 15 min

$3K

54 claims · 0.0%

Your Cost: $54.31/claim|Median: $49.62
1.1× median
90846Top 5%

Family psychotherapy without patient, 50 min

$3K

15 claims · 0.0%

Your Cost: $172.07/claim|Median: $76.61
2.3× median
90899Normal range

Unlisted psychiatric service/procedure

$3K

30 claims · 0.0%

Your Cost: $85.00/claim|Median: $30.72
2.8× median

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