Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

SPECIALIZED COMMUNITY CARE, INC

Community/Behavioral Health·MIDDLEBURY, VT·NPI: 1275651267Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $60.9M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-012024-11(83 months)

Total Paid

$60.9M

$60,903,367

Total Claims

64K

Beneficiaries

11K

5.6 claims/patient

Avg Cost/Claim

$949

Monthly Spending Trend

Yearly Spending

2018
$7.8M
+6%
2019
$8.3M
+2%
2020
$8.5M
+1%
2021
$8.6M
+5%
2022
$9.0M
-1%
2023
$8.9M
+10%
2024
$9.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 9 distinct procedure codes. The top code (99199 (Unlisted special service, procedure, or report)) accounts for 67% of total spending.

99199Top 1%

Unlisted special service, procedure, or report

$40.5M

3,811 claims · 66.6%

Your Cost: $10,635.51/claim|Median: $5.39
1973.2× median
H2022Top 10%

Community-based wrap-around services, per diem

$20.4M

5,555 claims · 33.4%

Your Cost: $3,667.22/claim|Median: $336.31
10.9× median
S0215Normal range

Non-invasive prenatal screening, fetal chromosomal abnormalities

$0

547 claims · 0.0%

Your Cost: $0.00/claim|Median: $21.33
S5150Normal range

Unskilled respite care, per 15 min

$0

9,437 claims · 0.0%

Your Cost: $0.00/claim|Median: $84.46
T2021Normal range

Day habilitation, waiver; per 15 min

$0

10K claims · 0.0%

Your Cost: $0.00/claim|Median: $150.51
T1016Normal range

Case management, each 15 min

$0

31K claims · 0.0%

Your Cost: $0.00/claim|Median: $49.62
S5151Normal range

Unskilled respite care, per diem

$0

1,448 claims · 0.0%

Your Cost: $0.00/claim|Median: $249.18
T2016Normal range

Habilitation, residential, waiver; per diem

$0

633 claims · 0.0%

Your Cost: $0.00/claim|Median: $331.94
S5140Normal range

Foster care, adult; per diem

$0

1,166 claims · 0.0%

Your Cost: $0.00/claim|Median: $252.32