Is LAMOILLE COUNTY HEALTH MENTAL HEALTH SERVICES flagged for Medicaid fraud?

LAMOILLE COUNTY HEALTH MENTAL HEALTH SERVICES (NPI: 1144347824) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

What is NPI 1144347824?

NPI 1144347824 is the National Provider Identifier for LAMOILLE COUNTY HEALTH MENTAL HEALTH SERVICES. They are a Community/Behavioral Health provider based in MORRISVILLE, VT. This NPI is registered with the CMS NPI Registry.

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LAMOILLE COUNTY HEALTH MENTAL HEALTH SERVICES

Community/Behavioral Health·MORRISVILLE, VT·NPI: 1144347824Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $42.7M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$42.7M

$42,738,233

Total Claims

191K

Beneficiaries

25K

7.7 claims/patient

Avg Cost/Claim

$224

Monthly Spending Trend

Yearly Spending

2018

$3.8M

-18%

2019

$3.1M

+3%

2020

$3.2M

+44%

2021

$4.6M

+81%

2022

$8.4M

+20%

2023

$10.0M

-6%

2024

$9.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 15 distinct procedure codes. The top code (99199 (Unlisted special service, procedure, or report)) accounts for 79% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

99199Unlisted special service, procedure, or reportSee all providers →

$33.6M

4,834 claims

$6,954.47

$5.39

1290.3×

Top 1%

99199Top 1%

Unlisted special service, procedure, or report

$33.6M

4,834 claims · 78.7%

Your Cost: $6,954.47/claim|Median: $5.39

1290.3× median

H2022Community-based wrap-around services, per diemSee all providers →

$9.1M

4,195 claims

$2,164.54

$336.31

6.4×

Top 25%

H2022Top 25%

Community-based wrap-around services, per diem

$9.1M

4,195 claims · 21.2%

Your Cost: $2,164.54/claim|Median: $336.31

6.4× median

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

$32K

1,610 claims

$19.94

$91.63

0.2×

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

$32K

1,610 claims · 0.1%

Your Cost: $19.94/claim|Median: $91.63

0.2× median

H2015Comprehensive community support services, per 15 minSee all providers →

$8K

386 claims

$20.67

$96.24

0.2×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$8K

386 claims · 0.0%

Your Cost: $20.67/claim|Median: $96.24

0.2× median

T2017Habilitation, residential, waiver; 15 minSee all providers →

230 claims

$0.00

$137.32

—

Normal range

T2017Normal range

Habilitation, residential, waiver; 15 min

230 claims · 0.0%

Your Cost: $0.00/claim|Median: $137.32

HW151 See all providers →

12 claims

$0.00

—

HW151

12 claims · 0.0%

S5150Unskilled respite care, per 15 minSee all providers →

11K claims

$0.00

$84.46

—

Normal range

S5150Normal range

Unskilled respite care, per 15 min

11K claims · 0.0%

Your Cost: $0.00/claim|Median: $84.46

S5151Unskilled respite care, per diemSee all providers →

9,306 claims

$0.00

$249.18

—

Normal range

S5151Normal range

Unskilled respite care, per diem

9,306 claims · 0.0%

Your Cost: $0.00/claim|Median: $249.18

HW015 See all providers →

54 claims

$0.00

—

HW015

54 claims · 0.0%

T2019Habilitation, prevocational, waiver; per 15 minSee all providers →

340 claims

$0.00

$88.91

—

Normal range

T2019Normal range

Habilitation, prevocational, waiver; per 15 min

340 claims · 0.0%

Your Cost: $0.00/claim|Median: $88.91

S5140Foster care, adult; per diemSee all providers →

66K claims

$0.00

$252.32

—

Normal range

S5140Normal range

Foster care, adult; per diem

66K claims · 0.0%

Your Cost: $0.00/claim|Median: $252.32

T1016Case management, each 15 minSee all providers →

45K claims

$0.00

$49.62

—

Normal range

T1016Normal range

Case management, each 15 min

45K claims · 0.0%

Your Cost: $0.00/claim|Median: $49.62

H2025Ongoing support to maintain employment, per 15 minSee all providers →

16K claims

$0.00

$100.49

—

Normal range

H2025Normal range

Ongoing support to maintain employment, per 15 min

16K claims · 0.0%

Your Cost: $0.00/claim|Median: $100.49

H2023Supported employment, per 15 minSee all providers →

4,021 claims

$0.00

$103.94

—

Normal range

H2023Normal range

Supported employment, per 15 min

4,021 claims · 0.0%

Your Cost: $0.00/claim|Median: $103.94

T2021Day habilitation, waiver; per 15 minSee all providers →

28K claims

$0.00

$150.51

—

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

28K claims · 0.0%

Your Cost: $0.00/claim|Median: $150.51

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