Is FAMILY GUIDANCE CENTER FOR BEHAVIORAL HEALTHCARE flagged for Medicaid fraud?

FAMILY GUIDANCE CENTER FOR BEHAVIORAL HEALTHCARE (NPI: 1164964235) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

What is NPI 1164964235?

NPI 1164964235 is the National Provider Identifier for FAMILY GUIDANCE CENTER FOR BEHAVIORAL HEALTHCARE. They are a Community/Behavioral Health provider based in SAINT JOSEPH, MO. This NPI is registered with the CMS NPI Registry.

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FAMILY GUIDANCE CENTER FOR BEHAVIORAL HEALTHCARE

Community/Behavioral Health·SAINT JOSEPH, MO·NPI: 1164964235Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $63.3M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$63.3M

$63,329,686

Total Claims

852K

Beneficiaries

327K

2.6 claims/patient

Avg Cost/Claim

$74

Monthly Spending Trend

Yearly Spending

2018

$8.3M

-16%

2019

$6.9M

+17%

2020

$8.1M

+3%

2021

$8.3M

+6%

2022

$8.8M

+30%

2023

$11.5M

-0%

2024

$11.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 26 distinct procedure codes. The top code (T1040 (Medicaid certified CCBHC services)) accounts for 100% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1040Medicaid certified CCBHC servicesSee all providers →

$63.2M

307K claims

$205.92

$130.29

1.6×

Normal range

T1040Normal range

Medicaid certified CCBHC services

$63.2M

307K claims · 99.8%

Your Cost: $205.92/claim|Median: $130.29

1.6× median

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

$84K

29K claims

$2.87

$37.81

0.1×

Normal range

99213Normal range

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

$84K

29K claims · 0.1%

Your Cost: $2.87/claim|Median: $37.81

0.1× median

90832Psychotherapy, 30 minutesSee all providers →

$46K

5,350 claims

$8.64

$41.28

0.2×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$46K

5,350 claims · 0.1%

Your Cost: $8.64/claim|Median: $41.28

0.2× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$7K

1,473 claims

$4.47

$53.41

0.1×

Normal range

99214Normal range

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

$7K

1,473 claims · 0.0%

Your Cost: $4.47/claim|Median: $53.41

0.1× median

99212Office/outpatient visit, low complexitySee all providers →

$7K

6,615 claims

$0.99

$25.06

0.0×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$7K

6,615 claims · 0.0%

Your Cost: $0.99/claim|Median: $25.06

0.0× median

90834Psychotherapy, 45 minutesSee all providers →

$3K

1,292 claims

$2.54

$63.65

0.0×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$3K

1,292 claims · 0.0%

Your Cost: $2.54/claim|Median: $63.65

0.0× median

90791Psychiatric diagnostic evaluationSee all providers →

$3K

479 claims

$6.34

$99.21

0.1×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$3K

479 claims · 0.0%

Your Cost: $6.34/claim|Median: $99.21

0.1× median

90837Psychotherapy, 60 minutesSee all providers →

$2K

112 claims

$15.03

$85.66

0.2×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$2K

112 claims · 0.0%

Your Cost: $15.03/claim|Median: $85.66

0.2× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

$743

881 claims

$0.84

$57.85

0.0×

Normal range

99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$743

881 claims · 0.0%

Your Cost: $0.84/claim|Median: $57.85

0.0× median

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

25K claims

$0.00

$55.04

—

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

25K claims · 0.0%

Your Cost: $0.00/claim|Median: $55.04

H0002Behavioral health screeningSee all providers →

12K claims

$0.00

$38.77

—

Normal range

H0002Normal range

Behavioral health screening

12K claims · 0.0%

Your Cost: $0.00/claim|Median: $38.77

H0036Community psychiatric supportive treatment, per 15 minSee all providers →

264K claims

$0.00

$76.05

—

Normal range

H0036Normal range

Community psychiatric supportive treatment, per 15 min

264K claims · 0.0%

Your Cost: $0.00/claim|Median: $76.05

99202Office/outpatient visit, new patient, low complexitySee all providers →

19 claims

$0.00

$40.11

—

Normal range

99202Normal range

Office/outpatient visit, new patient, low complexity

19 claims · 0.0%

Your Cost: $0.00/claim|Median: $40.11

H0032Mental health service plan developmentSee all providers →

6,213 claims

$0.00

$80.64

—

Normal range

H0032Normal range

Mental health service plan development

6,213 claims · 0.0%

Your Cost: $0.00/claim|Median: $80.64

H2010Comprehensive medication services, per 15 minSee all providers →

31K claims

$0.00

$62.69

—

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

31K claims · 0.0%

Your Cost: $0.00/claim|Median: $62.69

H2011Crisis intervention service, per 15 minutesSee all providers →

1,594 claims

$0.00

$215.80

—

Normal range

H2011Normal range

Crisis intervention service, per 15 minutes

1,594 claims · 0.0%

Your Cost: $0.00/claim|Median: $215.80

H0001Alcohol and/or drug assessmentSee all providers →

80 claims

$0.00

$94.22

—

Normal range

H0001Normal range

Alcohol and/or drug assessment

80 claims · 0.0%

Your Cost: $0.00/claim|Median: $94.22

H0040Assertive community treatment, face-to-face, per 15 minutesSee all providers →

13K claims

$0.00

$266.41

—

Normal range

H0040Normal range

Assertive community treatment, face-to-face, per 15 minutes

13K claims · 0.0%

Your Cost: $0.00/claim|Median: $266.41

H0025Behavioral health prevention education, per sessionSee all providers →

32K claims

$0.00

$36.25

—

Normal range

H0025Normal range

Behavioral health prevention education, per session

32K claims · 0.0%

Your Cost: $0.00/claim|Median: $36.25

H0005Alcohol and/or drug services, group counselingSee all providers →

23K claims

$0.00

$47.35

—

Normal range

H0005Normal range

Alcohol and/or drug services, group counseling

23K claims · 0.0%

Your Cost: $0.00/claim|Median: $47.35

H2015Comprehensive community support services, per 15 minSee all providers →

11K claims

$0.00

$96.24

—

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

11K claims · 0.0%

Your Cost: $0.00/claim|Median: $96.24

H2014Skills training & development, per 15 minSee all providers →

251 claims

$0.00

$83.88

—

Normal range

H2014Normal range

Skills training & development, per 15 min

251 claims · 0.0%

Your Cost: $0.00/claim|Median: $83.88

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

13K claims

$0.00

$91.63

—

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

13K claims · 0.0%

Your Cost: $0.00/claim|Median: $91.63

T1003LPN/LVN services, per 15 minutesSee all providers →

562 claims

$0.00

$24.24

—

Normal range

T1003Normal range

LPN/LVN services, per 15 minutes

562 claims · 0.0%

Your Cost: $0.00/claim|Median: $24.24

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

67K claims

$0.00

$74.63

—

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

67K claims · 0.0%

Your Cost: $0.00/claim|Median: $74.63

H2012Behavioral health day treatment, per hourSee all providers →

529 claims

$0.00

$137.86

—

Normal range

H2012Normal range

Behavioral health day treatment, per hour

529 claims · 0.0%

Your Cost: $0.00/claim|Median: $137.86

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