Rutland Mental Health Services
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $5,862.86 per claim for 99199 (Unlisted special service, procedure, or report), which is 1087.7× the national median of $5.39.
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.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $5,862.86 per claim for 99199 (Unlisted special service, procedure, or report) — 1087.7× the national median of $5.39.
Bills $2,089.36 per claim for H2022 (Community-based wrap-around services, per diem) — 6.2× the national median of $336.31.
Billing in the top 1% nationally for 1 procedure code: 99199.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center Developmental Disabilities Peers
Total spending distribution among 10 providers in this specialty
This provider's total spending of $122.1M is at the below 25th percentile among 10 Clinic/Center Developmental Disabilities providers.
Total Paid
$122.1M
$122,081,974
Total Claims
194K
Beneficiaries
47K
4.1 claims/patient
Avg Cost/Claim
$630
#977 of 618K providers by total spending(top 0.2%)
🔍 Analysis
Provider Overview
Rutland Mental Health Services is a Clinic/Center Developmental Disabilities provider based in Rutland, VT. From the 2018–2024 period, this provider received $122.1M in Medicaid payments across 194K claims.
Why This Matters
This provider received $122.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,260 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 12 distinct procedure codes. The top code (99199 (Unlisted special service, procedure, or report)) accounts for 68% of total spending.
$83.1M
14K claims
$5,862.86
$5.39
Unlisted special service, procedure, or report
$83.1M
14K claims · 68.0%
$38.9M
19K claims
$2,089.36
$336.31
Community-based wrap-around services, per diem
$38.9M
19K claims · 31.8%
Psychotherapy, 60 minutes
$128K
943 claims · 0.1%
$381
28 claims
$13.62
$25.06
Office/outpatient visit, low complexity
$381
28 claims · 0.0%
Case management, each 15 min
$0
36K claims · 0.0%
$0
15K claims
$0.00
$100.49
Ongoing support to maintain employment, per 15 min
$0
15K claims · 0.0%
Unskilled respite care, per 15 min
$0
43K claims · 0.0%
Day habilitation, waiver; per 15 min
$0
37K claims · 0.0%
$0
12K claims
$0.00
$137.32
Habilitation, residential, waiver; 15 min
$0
12K claims · 0.0%
Unskilled respite care, per diem
$0
9K claims · 0.0%
Foster care, adult; per diem
$0
6K claims · 0.0%
Supported employment, per 15 min
$0
1K claims · 0.0%
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