Is CHILDREN'S SERVICES OF ROXBURY, INC. flagged for Medicaid fraud?

CHILDREN'S SERVICES OF ROXBURY, INC. (NPI: 1124253794) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does CHILDREN'S SERVICES OF ROXBURY, INC. bill Medicaid?

CHILDREN'S SERVICES OF ROXBURY, INC. received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in ROXBURY, MA.

What is NPI 1124253794?

NPI 1124253794 is the National Provider Identifier for CHILDREN'S SERVICES OF ROXBURY, INC.. They are a Community/Behavioral Health provider based in ROXBURY, MA. This NPI is registered with the CMS NPI Registry.

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CHILDREN'S SERVICES OF ROXBURY, INC.

Community/Behavioral Health·ROXBURY, MA·NPI: 1124253794Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $59.1M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$59.1M

$59,102,885

Total Claims

808K

Beneficiaries

63K

12.8 claims/patient

Avg Cost/Claim

$73

Monthly Spending Trend

Yearly Spending

2018

$8.6M

+11%

2019

$9.5M

+1%

2020

$9.6M

-3%

2021

$9.4M

-13%

2022

$8.2M

-11%

2023

$7.3M

-11%

2024

$6.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (H0023 (Behavioral health outreach service, per 15 minutes)) accounts for 53% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0023Behavioral health outreach service, per 15 minutesSee all providers →

$31.1M

585K claims

$53.15

$53.97

1.0×

Normal range

H0023Normal range

Behavioral health outreach service, per 15 minutes

$31.1M

585K claims · 52.6%

Your Cost: $53.15/claim|Median: $53.97

1.0× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$13.1M

82K claims

$159.26

$84.12

1.9×

Top 25%

H2019Top 25%

Therapeutic behavioral services, per 15 min

$13.1M

82K claims · 22.2%

Your Cost: $159.26/claim|Median: $84.12

1.9× median

T1027Family training and counseling, per 15 minutesSee all providers →

$5.9M

40K claims

$146.89

$53.00

2.8×

Top 5%

T1027Top 5%

Family training and counseling, per 15 minutes

$5.9M

40K claims · 10.0%

Your Cost: $146.89/claim|Median: $53.00

2.8× median

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

$3.1M

33K claims

$95.11

$55.04

1.7×

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

$3.1M

33K claims · 5.3%

Your Cost: $95.11/claim|Median: $55.04

1.7× median

T1017Targeted case management, per 15 minSee all providers →

$2.2M

17K claims

$131.93

$69.56

1.9×

Normal range

T1017Normal range

Targeted case management, per 15 min

$2.2M

17K claims · 3.8%

Your Cost: $131.93/claim|Median: $69.56

1.9× median

90834Psychotherapy, 45 minutesSee all providers →

$1.6M

19K claims

$83.35

$63.65

1.3×

Top 25%

90834Top 25%

Psychotherapy, 45 minutes

$1.6M

19K claims · 2.7%

Your Cost: $83.35/claim|Median: $63.65

1.3× median

90887Interpretation/explanation of resultsSee all providers →

$1.2M

15K claims

$77.96

$47.55

1.6×

Top 25%

90887Top 25%

Interpretation/explanation of results

$1.2M

15K claims · 1.9%

Your Cost: $77.96/claim|Median: $47.55

1.6× median

H0046Mental health services, not otherwise specifiedSee all providers →

$435K

9,881 claims

$44.07

$85.02

0.5×

Normal range

H0046Normal range

Mental health services, not otherwise specified

$435K

9,881 claims · 0.7%

Your Cost: $44.07/claim|Median: $85.02

0.5× median

90882Environmental interventionSee all providers →

$403K

7,053 claims

$57.16

$45.05

1.3×

Normal range

90882Normal range

Environmental intervention

$403K

7,053 claims · 0.7%

Your Cost: $57.16/claim|Median: $45.05

1.3× median

90791Psychiatric diagnostic evaluationSee all providers →

$77K

617 claims

$125.20

$99.21

1.3×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$77K

617 claims · 0.1%

Your Cost: $125.20/claim|Median: $99.21

1.3× median

90837Psychotherapy, 60 minutesSee all providers →

$13K

154 claims

$81.64

$85.66

1.0×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$13K

154 claims · 0.0%

Your Cost: $81.64/claim|Median: $85.66

1.0× median

H0031Mental health assessment by non-physicianSee all providers →

$180

12 claims

$15.00

$96.18

0.2×

Normal range

H0031Normal range

Mental health assessment by non-physician

$180

12 claims · 0.0%

Your Cost: $15.00/claim|Median: $96.18

0.2× median

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