Is BEHAVIORAL OUTCOMES MANAGEMENT,LLC flagged for Medicaid fraud?

BEHAVIORAL OUTCOMES MANAGEMENT,LLC (NPI: 1184139131) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does BEHAVIORAL OUTCOMES MANAGEMENT,LLC bill Medicaid?

BEHAVIORAL OUTCOMES MANAGEMENT,LLC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in TROY, MI.

What is NPI 1184139131?

NPI 1184139131 is the National Provider Identifier for BEHAVIORAL OUTCOMES MANAGEMENT,LLC. They are a Community/Behavioral Health provider based in TROY, MI. This NPI is registered with the CMS NPI Registry.

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BEHAVIORAL OUTCOMES MANAGEMENT,LLC

Community/Behavioral Health·TROY, MI·NPI: 1184139131Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $48.8M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$48.8M

$48,831,785

Total Claims

507K

Beneficiaries

63K

8.1 claims/patient

Avg Cost/Claim

$96

Monthly Spending Trend

Yearly Spending

2018

$9.5M

-55%

2019

$4.3M

-9%

2020

$3.9M

-4%

2021

$3.8M

+16%

2022

$4.4M

+46%

2023

$6.4M

+155%

2024

$16.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 14 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 71% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2015Comprehensive community support services, per 15 minSee all providers →

$34.9M

332K claims

$104.98

$96.24

1.1×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$34.9M

332K claims · 71.4%

Your Cost: $104.98/claim|Median: $96.24

1.1× median

T1005Respite care services, per 15 minutesSee all providers →

$7.5M

106K claims

$71.20

$71.40

1.0×

Normal range

T1005Normal range

Respite care services, per 15 minutes

$7.5M

106K claims · 15.4%

Your Cost: $71.20/claim|Median: $71.40

1.0× median

S5111Home care training, family member, per sessionSee all providers →

$1.9M

18K claims

$102.55

$87.13

1.2×

Normal range

S5111Normal range

Home care training, family member, per session

$1.9M

18K claims · 3.8%

Your Cost: $102.55/claim|Median: $87.13

1.2× median

H0043Supported housing, per diemSee all providers →

$1.3M

16K claims

$78.45

$164.87

0.5×

Normal range

H0043Normal range

Supported housing, per diem

$1.3M

16K claims · 2.6%

Your Cost: $78.45/claim|Median: $164.87

0.5× median

92507Speech/hearing/language treatmentSee all providers →

$1.2M

13K claims

$97.79

$49.45

2.0×

Top 10%

92507Top 10%

Speech/hearing/language treatment

$1.2M

13K claims · 2.5%

Your Cost: $97.79/claim|Median: $49.45

2.0× median

97530Therapeutic activities, each 15 minSee all providers →

$1.1M

11K claims

$99.96

$33.11

3.0×

Top 10%

97530Top 10%

Therapeutic activities, each 15 min

$1.1M

11K claims · 2.2%

Your Cost: $99.96/claim|Median: $33.11

3.0× median

97110Therapeutic exercises, each 15 minSee all providers →

$385K

4,355 claims

$88.45

$24.49

3.6×

Top 5%

97110Top 5%

Therapeutic exercises, each 15 min

$385K

4,355 claims · 0.8%

Your Cost: $88.45/claim|Median: $24.49

3.6× median

H0032Mental health service plan developmentSee all providers →

$301K

2,679 claims

$112.47

$80.64

1.4×

Normal range

H0032Normal range

Mental health service plan development

$301K

2,679 claims · 0.6%

Your Cost: $112.47/claim|Median: $80.64

1.4× median

97533 See all providers →

$151K

3,003 claims

$50.37

$48.71

1.0×

Normal range

97533Normal range

$151K

3,003 claims · 0.3%

Your Cost: $50.37/claim|Median: $48.71

1.0× median

92523Evaluation of speech sound production with language comprehensionSee all providers →

$43K

278 claims

$154.32

$110.87

1.4×

Top 25%

92523Top 25%

Evaluation of speech sound production with language comprehension

$43K

278 claims · 0.1%

Your Cost: $154.32/claim|Median: $110.87

1.4× median

97168OT re-evaluationSee all providers →

$29K

297 claims

$98.13

$50.43

1.9×

Top 25%

97168Top 25%

OT re-evaluation

$29K

297 claims · 0.1%

Your Cost: $98.13/claim|Median: $50.43

1.9× median

97550 See all providers →

$26K

323 claims

$81.43

$10.32

7.9×

Top 1%

97550Top 1%

$26K

323 claims · 0.1%

Your Cost: $81.43/claim|Median: $10.32

7.9× median

S9445 See all providers →

$900

12 claims

$75.00

$12.72

5.9×

Top 10%

S9445Top 10%

$900

12 claims · 0.0%

Your Cost: $75.00/claim|Median: $12.72

5.9× median

97165OT evaluation, low complexitySee all providers →

$664

12 claims

$55.34

$46.78

1.2×

Normal range

97165Normal range

OT evaluation, low complexity

$664

12 claims · 0.0%

Your Cost: $55.34/claim|Median: $46.78

1.2× median

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