Is COLLABORATIVE AUTISM MANAGEMENT PROGRAMS INC. flagged for Medicaid fraud?

COLLABORATIVE AUTISM MANAGEMENT PROGRAMS INC. (NPI: 1265995435) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

What is NPI 1265995435?

NPI 1265995435 is the National Provider Identifier for COLLABORATIVE AUTISM MANAGEMENT PROGRAMS INC.. They are a Behavior Analyst provider based in ONTARIO, CA. This NPI is registered with the CMS NPI Registry.

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COLLABORATIVE AUTISM MANAGEMENT PROGRAMS INC.

Behavior Analyst·ONTARIO, CA·NPI: 1265995435Share

Compared to Behavior Analyst Peers

Total spending distribution among 31 providers in this specialty

P25MedianP75P90

This provider's total spending of $29.3M is at the 75th percentile among 31 Behavior Analyst providers.

Active Billing Period:2019-07→2024-11(65 months)

Total Paid

$29.3M

$29,267,657

Total Claims

98K

Beneficiaries

30K

3.2 claims/patient

Avg Cost/Claim

$297

Monthly Spending Trend

Yearly Spending

2019

$500K

+369%

2020

$2.3M

+70%

2021

$4.0M

+48%

2022

$5.9M

+32%

2023

$7.8M

+13%

2024

$8.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (H0032 (Mental health service plan development)) accounts for 77% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0032Mental health service plan developmentSee all providers →

$22.5M

66K claims

$343.82

$80.64

4.3×

Top 5%

H0032Top 5%

Mental health service plan development

$22.5M

66K claims · 77.0%

Your Cost: $343.82/claim|Median: $80.64

4.3× median

96137Psychological/neuropsychological testing, each additional 30 minSee all providers →

$1.8M

2,877 claims

$625.06

$92.96

6.7×

Top 5%

96137Top 5%

Psychological/neuropsychological testing, each additional 30 min

$1.8M

2,877 claims · 6.1%

Your Cost: $625.06/claim|Median: $92.96

6.7× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$928K

7,000 claims

$132.61

$84.12

1.6×

Top 25%

H2019Top 25%

Therapeutic behavioral services, per 15 min

$928K

7,000 claims · 3.2%

Your Cost: $132.61/claim|Median: $84.12

1.6× median

96131Psychological testing evaluation, each additional hourSee all providers →

$776K

2,876 claims

$269.96

$133.38

2.0×

Top 25%

96131Top 25%

Psychological testing evaluation, each additional hour

$776K

2,876 claims · 2.7%

Your Cost: $269.96/claim|Median: $133.38

2.0× median

90791Psychiatric diagnostic evaluationSee all providers →

$656K

2,877 claims

$228.17

$99.21

2.3×

Top 5%

90791Top 5%

Psychiatric diagnostic evaluation

$656K

2,877 claims · 2.2%

Your Cost: $228.17/claim|Median: $99.21

2.3× median

96112Developmental test administrationSee all providers →

$597K

2,877 claims

$207.66

$102.95

2.0×

Top 25%

96112Top 25%

Developmental test administration

$597K

2,877 claims · 2.0%

Your Cost: $207.66/claim|Median: $102.95

2.0× median

96110Developmental screening, per standardized instrumentSee all providers →

$562K

2,876 claims

$195.56

$9.10

21.5×

Top 1%

96110Top 1%

Developmental screening, per standardized instrument

$562K

2,876 claims · 1.9%

Your Cost: $195.56/claim|Median: $9.10

21.5× median

96130Psychological testing evaluation by professional, first hourSee all providers →

$511K

2,877 claims

$177.49

$79.21

2.2×

Top 25%

96130Top 25%

Psychological testing evaluation by professional, first hour

$511K

2,877 claims · 1.7%

Your Cost: $177.49/claim|Median: $79.21

2.2× median

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

$423K

2,873 claims

$147.32

$111.09

1.3×

Normal range

99205Normal range

Office/outpatient visit, new patient, high complexity

$423K

2,873 claims · 1.4%

Your Cost: $147.32/claim|Median: $111.09

1.3× median

96113Developmental test admin, each additional 30 minSee all providers →

$266K

2,878 claims

$92.41

$77.06

1.2×

Normal range

96113Normal range

Developmental test admin, each additional 30 min

$266K

2,878 claims · 0.9%

Your Cost: $92.41/claim|Median: $77.06

1.2× median

96136Psychological/neuropsychological testing, first 30 minSee all providers →

$215K

2,876 claims

$74.63

$30.49

2.4×

Top 10%

96136Top 10%

Psychological/neuropsychological testing, first 30 min

$215K

2,876 claims · 0.7%

Your Cost: $74.63/claim|Median: $30.49

2.4× median

H0031Mental health assessment by non-physicianSee all providers →

$6K

22 claims

$256.70

$96.18

2.7×

Top 10%

H0031Top 10%

Mental health assessment by non-physician

$6K

22 claims · 0.0%

Your Cost: $256.70/claim|Median: $96.18

2.7× median

Other Top Providers in California

View all →

Los Angeles County Department of Mental Health

Clinic/Center, Mental Health (Including Community

$6.78B

County of Santa Clara

Community/Behavioral Health

$1.73B

County of Riverside

Community/Behavioral Health

$1.40B

City & County of San Francisco

Community/Behavioral Health

$1.34B

Los Angeles County Department of Public Health

Public Health or Welfare

$1.13B

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