Is PHOENIX HOUSES OF LONG ISLAND, INC. flagged for Medicaid fraud?

PHOENIX HOUSES OF LONG ISLAND, INC. (NPI: 1174691281) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does PHOENIX HOUSES OF LONG ISLAND, INC. bill Medicaid?

PHOENIX HOUSES OF LONG ISLAND, INC. received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Substance Abuse Rehabilitation Facility provider. Located in BRENTWOOD, NY.

What is NPI 1174691281?

NPI 1174691281 is the National Provider Identifier for PHOENIX HOUSES OF LONG ISLAND, INC.. They are a Substance Abuse Rehabilitation Facility provider based in BRENTWOOD, NY. This NPI is registered with the CMS NPI Registry.

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PHOENIX HOUSES OF LONG ISLAND, INC.

Substance Abuse Rehabilitation Facility·BRENTWOOD, NY·NPI: 1174691281Share

Compared to Substance Abuse Rehabilitation Facility Peers

Total spending distribution among 20 providers in this specialty

P25MedianP75P90

This provider's total spending of $59.4M is at the 50th percentile among 20 Substance Abuse Rehabilitation Facility providers.

Active Billing Period:2018-01→2024-12(79 months)

Total Paid

$59.4M

$59,443,900

Total Claims

262K

Beneficiaries

27K

9.7 claims/patient

Avg Cost/Claim

$227

Monthly Spending Trend

Yearly Spending

2018

$365K

+575%

2019

$2.5M

+143%

2020

$6.0M

+28%

2021

$7.7M

+67%

2022

$12.8M

+25%

2023

$16.0M

-11%

2024

$14.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 20 distinct procedure codes. The top code (H2036 (Alcohol/drug treatment, per hour)) accounts for 85% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2036Alcohol/drug treatment, per hourSee all providers →

$50.4M

233K claims

$216.68

$253.79

0.9×

Normal range

H2036Normal range

Alcohol/drug treatment, per hour

$50.4M

233K claims · 84.8%

Your Cost: $216.68/claim|Median: $253.79

0.9× median

H2018Psychosocial rehabilitation services, per diemSee all providers →

$3.2M

1,697 claims

$1,914.82

$392.63

4.9×

Top 25%

H2018Top 25%

Psychosocial rehabilitation services, per diem

$3.2M

1,697 claims · 5.5%

Your Cost: $1,914.82/claim|Median: $392.63

4.9× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$2.5M

3,155 claims

$781.61

$84.12

9.3×

Top 5%

H2019Top 5%

Therapeutic behavioral services, per 15 min

$2.5M

3,155 claims · 4.1%

Your Cost: $781.61/claim|Median: $84.12

9.3× median

90899Unlisted psychiatric service/procedureSee all providers →

$802K

197 claims

$4,071.52

$30.72

132.5×

Top 1%

90899Top 1%

Unlisted psychiatric service/procedure

$802K

197 claims · 1.3%

Your Cost: $4,071.52/claim|Median: $30.72

132.5× median

90834Psychotherapy, 45 minutesSee all providers →

$759K

5,319 claims

$142.61

$63.65

2.2×

Top 5%

90834Top 5%

Psychotherapy, 45 minutes

$759K

5,319 claims · 1.3%

Your Cost: $142.61/claim|Median: $63.65

2.2× median

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$602K

2,020 claims

$298.05

$121.16

2.5×

Top 5%

T1015Top 5%

Clinic visit/encounter, all-inclusive

$602K

2,020 claims · 1.0%

Your Cost: $298.05/claim|Median: $121.16

2.5× median

90853Group psychotherapySee all providers →

$599K

11K claims

$57.09

$25.02

2.3×

Top 25%

90853Top 25%

Group psychotherapy

$599K

11K claims · 1.0%

Your Cost: $57.09/claim|Median: $25.02

2.3× median

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

$185K

3,634 claims

$51.01

$47.35

1.1×

Normal range

H0005Normal range

Alcohol and/or drug services, group counseling

$185K

3,634 claims · 0.3%

Your Cost: $51.01/claim|Median: $47.35

1.1× median

G0397 See all providers →

$115K

894 claims

$128.89

$142.31

0.9×

Normal range

G0397Normal range

$115K

894 claims · 0.2%

Your Cost: $128.89/claim|Median: $142.31

0.9× median

99205Office/outpatient visit, new patient, high complexitySee all providers →

$66K

440 claims

$150.95

$111.09

1.4×

Normal range

99205Normal range

Office/outpatient visit, new patient, high complexity

$66K

440 claims · 0.1%

Your Cost: $150.95/claim|Median: $111.09

1.4× median

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

$66K

452 claims

$145.02

$53.41

2.7×

Top 5%

99214Top 5%

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

$66K

452 claims · 0.1%

Your Cost: $145.02/claim|Median: $53.41

2.7× median

H0001Alcohol and/or drug assessmentSee all providers →

$42K

303 claims

$139.81

$94.22

1.5×

Normal range

H0001Normal range

Alcohol and/or drug assessment

$42K

303 claims · 0.1%

Your Cost: $139.81/claim|Median: $94.22

1.5× median

90832Psychotherapy, 30 minutesSee all providers →

$18K

151 claims

$119.97

$41.28

2.9×

Top 10%

90832Top 10%

Psychotherapy, 30 minutes

$18K

151 claims · 0.0%

Your Cost: $119.97/claim|Median: $41.28

2.9× median

90791Psychiatric diagnostic evaluationSee all providers →

$17K

93 claims

$187.58

$99.21

1.9×

Top 10%

90791Top 10%

Psychiatric diagnostic evaluation

$17K

93 claims · 0.0%

Your Cost: $187.58/claim|Median: $99.21

1.9× median

H2016Comprehensive community support services, per 15 minSee all providers →

$13K

15 claims

$856.67

$321.53

2.7×

Top 25%

H2016Top 25%

Comprehensive community support services, per 15 min

$13K

15 claims · 0.0%

Your Cost: $856.67/claim|Median: $321.53

2.7× median

90837Psychotherapy, 60 minutesSee all providers →

$12K

76 claims

$152.80

$85.66

1.8×

Top 5%

90837Top 5%

Psychotherapy, 60 minutes

$12K

76 claims · 0.0%

Your Cost: $152.80/claim|Median: $85.66

1.8× median

S9480Intensive outpatient psychiatric services, per diemSee all providers →

$11K

107 claims

$103.32

$135.70

0.8×

Normal range

S9480Normal range

Intensive outpatient psychiatric services, per diem

$11K

107 claims · 0.0%

Your Cost: $103.32/claim|Median: $135.70

0.8× median

96372Therapeutic injection, subcutaneous/intramuscularSee all providers →

$8K

645 claims

$11.68

$9.56

1.2×

Normal range

96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$8K

645 claims · 0.0%

Your Cost: $11.68/claim|Median: $9.56

1.2× median

G0396Alcohol/substance abuse structured assessment, 15-30 minutesSee all providers →

$6K

62 claims

$100.50

$40.58

2.5×

Top 25%

G0396Top 25%

Alcohol/substance abuse structured assessment, 15-30 minutes

$6K

62 claims · 0.0%

Your Cost: $100.50/claim|Median: $40.58

2.5× median

H0014 See all providers →

$5K

32 claims

$166.69

$137.81

1.2×

Normal range

H0014Normal range

$5K

32 claims · 0.0%

Your Cost: $166.69/claim|Median: $137.81

1.2× median

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