Bridgeway Behavioral Health Services
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $1,537.53 per claim for H0040 (Assertive community treatment, face-to-face, per 15 minutes), which is 5.8× the national median of $266.41.
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code H0040 (1 unique codes).
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Compared to Case Management Peers
Total spending distribution among 137 providers in this specialty
This provider's total spending of $62.4M is at the 25th percentile among 137 Case Management providers.
Total Paid
$62.4M
$62,417,452
Total Claims
41K
Beneficiaries
41K
1.0 claims/patient
Avg Cost/Claim
$2K
🔍 Analysis
Provider Overview
Bridgeway Behavioral Health Services is a Case Management provider based in Elizabeth, NJ. From the 2018–2024 period, this provider received $62.4M in Medicaid payments across 41K claims.
Important Context
- ℹ️This provider appears to operate as a fiscal intermediary or management organization, processing payments on behalf of many individual caregivers. High aggregate billing is expected for this type of entity.
Why This Matters
At $62.4M in Medicaid payments, this provider represents significant public healthcare spending. Understanding where these dollars go helps ensure the program serves those who need it most.
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