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

Beth Israel Medical Center

Psychiatric Unit·Brooklyn, NY·NPI: 1174689665SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

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

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Change PointBilling shifted 22.4x in 2019-09

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $229.34 per claim for G2067 (Medication-assisted treatment, opioid use disorder, per month) — 3.1× the national median of $73.29.

Bills $921.39 per claim for 90791 (Psychiatric diagnostic evaluation) — 9.3× the national median of $99.21.

Bills $168.17 per claim for 99283 (Emergency dept visit, moderate complexity) — 4.0× the national median of $42.48.

Billing in the top 1% nationally for 2 procedure codes: G2067, 90791.

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

Compared to Psychiatric Unit Peers

Total spending distribution among 8 providers in this specialty

P25MedianP75P90

This provider's total spending of $278.7M is at the 99th percentile among 8 Psychiatric Unit providers.

Above 99th percentile for this specialty — higher spending than 7 of 8 peers

Active Billing Period:2018-012024-12(84 months)

Total Paid

$278.7M

$278,662,434

Total Claims

4.4M

Beneficiaries

2.7M

1.6 claims/patient

Avg Cost/Claim

$63

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

🔍 Analysis

Provider Overview

Beth Israel Medical Center is a Psychiatric Unit provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $278.7M in Medicaid payments across 4.4M claims.

Why This Matters

This provider received $278.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 34,832 Medicaid beneficiaries for a full year at average per-enrollee costs.

3164% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$1.2M
+1742%
2019
$21.4M
+146%
2020
$52.6M
+2%
2021
$53.7M
+4%
2022
$55.6M
+1%
2023
$56.3M
-33%
2024
$37.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G2067 (Medication-assisted treatment, opioid use disorder, per month)) accounts for 16% of total spending.

G2067Top 1%

Medication-assisted treatment, opioid use disorder, per month

$43.4M

189K claims · 15.6%

Your Cost: $229.34/claim|Median: $73.29
3.1× median
H0020Normal range

Alcohol/drug services; methadone administration

$33.3M

989K claims · 12.0%

Your Cost: $33.70/claim|Median: $18.95
1.8× median
99214Top 10%

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

$21.4M

186K claims · 7.7%

Your Cost: $114.76/claim|Median: $53.41
2.1× median
99213Top 5%

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

$15.5M

137K claims · 5.6%

Your Cost: $113.03/claim|Median: $37.81
3.0× median
G0396Top 25%

Alcohol/substance abuse structured assessment, 15-30 minutes

$12.7M

119K claims · 4.6%

Your Cost: $107.30/claim|Median: $40.58
2.6× median
90791Top 1%

Psychiatric diagnostic evaluation

$9.6M

10K claims · 3.4%

Your Cost: $921.39/claim|Median: $99.21
9.3× median
J9271Top 10%

Injection, pembrolizumab, 1 mg

$9.5M

914 claims · 3.4%

Your Cost: $10,397.28/claim|Median: $5,391.55
1.9× median
99283Top 10%

Emergency dept visit, moderate complexity

$8.1M

48K claims · 2.9%

Your Cost: $168.17/claim|Median: $42.48
4.0× median
99284Top 25%

Emergency dept visit, high complexity

$5.2M

31K claims · 1.8%

Your Cost: $164.28/claim|Median: $69.51
2.4× median
H0040Top 10%

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

$5.1M

3K claims · 1.8%

Your Cost: $1,842.97/claim|Median: $266.41
6.9× median
99215Top 25%

Office/outpatient visit, high complexity

$4.2M

30K claims · 1.5%

Your Cost: $140.14/claim|Median: $74.09
1.9× median
90834Top 5%

Psychotherapy, 45 minutes

$4.1M

24K claims · 1.5%

Your Cost: $170.92/claim|Median: $63.65
2.7× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$4.1M

27K claims · 1.5%

Your Cost: $151.24/claim|Median: $85.65
1.8× median
99212Top 5%

Office/outpatient visit, low complexity

$3.4M

30K claims · 1.2%

Your Cost: $112.14/claim|Median: $25.06
4.5× median
99204Top 10%

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

$3.3M

22K claims · 1.2%

Your Cost: $155.47/claim|Median: $84.03
1.9× median
G0378Top 5%

Hospital observation service, per hour

$3.0M

3K claims · 1.1%

Your Cost: $972.00/claim|Median: $99.39
9.8× median
36415Top 10%

Collection of venous blood by venipuncture

$2.8M

349K claims · 1.0%

Your Cost: $8.09/claim|Median: $1.57
5.2× median
97110Top 25%

Therapeutic exercises, each 15 min

$2.6M

44K claims · 0.9%

Your Cost: $59.64/claim|Median: $24.49
2.4× median
G0397Normal range

$2.5M

18K claims · 0.9%

Your Cost: $142.32/claim|Median: $142.31
1.0× median
U0004Normal range

COVID-19 test, nucleic acid detection, CDC lab only

$2.4M

40K claims · 0.9%

Your Cost: $60.94/claim|Median: $60.05
1.0× median
96361Top 25%

IV infusion, hydration, each additional hour

$2.2M

12K claims · 0.8%

Your Cost: $178.62/claim|Median: $38.92
4.6× median
99203Top 5%

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

$2.1M

15K claims · 0.8%

Your Cost: $143.32/claim|Median: $57.85
2.5× median
J2426Top 25%

$1.7M

987 claims · 0.6%

Your Cost: $1,755.41/claim|Median: $625.59
2.8× median
J2505Top 25%

$1.7M

491 claims · 0.6%

Your Cost: $3,514.18/claim|Median: $1,842.27
1.9× median
96413Top 25%

Chemotherapy administration, IV infusion, up to 1 hour

$1.5M

9K claims · 0.6%

Your Cost: $164.35/claim|Median: $75.28
2.2× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$1.5M

30K claims · 0.5%

Your Cost: $51.62/claim|Median: $74.63
0.7× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$1.5M

7K claims · 0.5%

Your Cost: $209.06/claim|Median: $54.68
3.8× median
J0897Top 25%

Injection, denosumab, one milligram

$1.5M

1K claims · 0.5%

Your Cost: $1,421.70/claim|Median: $493.25
2.9× median
74177Top 25%

CT abdomen and pelvis with contrast

$1.3M

7K claims · 0.5%

Your Cost: $185.71/claim|Median: $65.76
2.8× median
G2078Top 25%

$1.2M

27K claims · 0.4%

Your Cost: $45.65/claim|Median: $27.04
1.7× median