Macomb County Community Mental Health
Clinic/Center Mental Health (Including Community Mental Health Center)
Clinton Twp, Michigan
NPI: 1255385399
Risk Tier
High
Total Paid
$300.0M
$299,955,612
Total Claims
1.2M
Beneficiaries
712K
Avg Cost/Claim
$247.40
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $281.97 per claim for T1017 (Targeted case management, per 15 min), which is 4.1× the national median of $69.56.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 32 procedure codes: T1017 at 4.1× median, 99214 at 5.6× median.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024