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EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

Community/Behavioral Health·RALEIGH, NC·NPI: 1306167713Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $58.3M is at the 50th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$58.3M

$58,302,470

Total Claims

329K

Beneficiaries

45K

7.3 claims/patient

Avg Cost/Claim

$177

Monthly Spending Trend

Yearly Spending

2018
$4.8M
+25%
2019
$6.0M
+14%
2020
$6.9M
+3%
2021
$7.0M
+30%
2022
$9.2M
+41%
2023
$13.0M
-12%
2024
$11.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 32 distinct procedure codes. The top code (H0040 (Assertive community treatment, face-to-face, per 15 minutes)) accounts for 24% of total spending.

H0040Normal range

Assertive community treatment, face-to-face, per 15 minutes

$13.8M

57K claims · 23.7%

Your Cost: $242.58/claim|Median: $266.41
0.9× median
H2022Normal range

Community-based wrap-around services, per diem

$7.6M

32K claims · 13.1%

Your Cost: $236.93/claim|Median: $336.31
0.7× median
S5145Normal range

Foster care, therapeutic, child, per diem

$6.7M

44K claims · 11.6%

Your Cost: $153.21/claim|Median: $216.31
0.7× median
T2013Normal range

Habilitation, residential, waiver, per hour

$6.4M

42K claims · 10.9%

Your Cost: $150.39/claim|Median: $158.23
1.0× median
T2012Normal range

Habilitation, educational; per 15 min

$3.8M

24K claims · 6.5%

Your Cost: $159.43/claim|Median: $177.54
0.9× median
H2023Top 25%

Supported employment, per 15 min

$3.7M

24K claims · 6.3%

Your Cost: $153.71/claim|Median: $103.94
1.5× median
H2033Top 25%

Multisystemic therapy for juveniles, per 15 minutes

$3.2M

8,626 claims · 5.4%

Your Cost: $367.46/claim|Median: $227.82
1.6× median
H2025Normal range

Ongoing support to maintain employment, per 15 min

$3.1M

20K claims · 5.2%

Your Cost: $153.87/claim|Median: $100.49
1.5× median
H2015Normal range

Comprehensive community support services, per 15 min

$2.6M

20K claims · 4.4%

Your Cost: $131.24/claim|Median: $96.24
1.4× median
90837Normal range

Psychotherapy, 60 minutes

$1.4M

18K claims · 2.4%

Your Cost: $78.63/claim|Median: $85.66
0.9× median
T2021Normal range

Day habilitation, waiver; per 15 min

$1.2M

8,181 claims · 2.1%

Your Cost: $151.69/claim|Median: $150.51
1.0× median
T1017Top 10%

Targeted case management, per 15 min

$1.1M

3,925 claims · 2.0%

Your Cost: $289.67/claim|Median: $69.56
4.2× median
H0038Top 10%

Self-help/peer services, per 15 minutes

$1.1M

3,066 claims · 1.8%

Your Cost: $349.66/claim|Median: $55.04
6.4× median
S5150Normal range

Unskilled respite care, per 15 min

$693K

5,428 claims · 1.2%

Your Cost: $127.67/claim|Median: $84.46
1.5× median
H2016Normal range

Comprehensive community support services, per 15 min

$423K

1,792 claims · 0.7%

Your Cost: $236.04/claim|Median: $321.53
0.7× median
T2025Normal range

Waiver services, NOS; per 15 min

$377K

2,028 claims · 0.6%

Your Cost: $185.72/claim|Median: $124.39
1.5× median
H0045Normal range

Respite care services, not in the home, per diem

$361K

3,593 claims · 0.6%

Your Cost: $100.35/claim|Median: $119.19
0.8× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$334K

4,482 claims · 0.6%

Your Cost: $74.45/claim|Median: $53.41
1.4× median
90791Normal range

Psychiatric diagnostic evaluation

$116K

1,255 claims · 0.2%

Your Cost: $92.49/claim|Median: $99.21
0.9× median
90847Normal range

Family psychotherapy with patient, 50 min

$100K

1,495 claims · 0.2%

Your Cost: $66.92/claim|Median: $77.33
0.9× median
T2041Normal range

Supports brokerage, self-directed; per 15 min

$72K

426 claims · 0.1%

Your Cost: $168.36/claim|Median: $162.29
1.0× median
T1019Normal range

Personal care services, per 15 min

$64K

1,506 claims · 0.1%

Your Cost: $42.76/claim|Median: $82.47
0.5× median
H2026Normal range

$60K

1,326 claims · 0.1%

Your Cost: $44.95/claim|Median: $76.18
0.6× median
90834Normal range

Psychotherapy, 45 minutes

$23K

422 claims · 0.0%

Your Cost: $54.20/claim|Median: $63.65
0.9× median
90832Normal range

Psychotherapy, 30 minutes

$9K

269 claims · 0.0%

Your Cost: $31.74/claim|Median: $41.28
0.8× median
99215Normal range

Office/outpatient visit, high complexity

$6K

58 claims · 0.0%

Your Cost: $95.40/claim|Median: $74.09
1.3× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$5K

39 claims · 0.0%

Your Cost: $137.90/claim|Median: $111.09
1.2× median
90846Normal range

Family psychotherapy without patient, 50 min

$3K

57 claims · 0.0%

Your Cost: $58.16/claim|Median: $76.61
0.8× median
99242Top 25%

Office consultation, low complexity

$1K

13 claims · 0.0%

Your Cost: $84.52/claim|Median: $57.97
1.5× median
98966Normal range

$128

14 claims · 0.0%

Your Cost: $9.13/claim|Median: $6.84
1.3× median
H0036Normal range

Community psychiatric supportive treatment, per 15 min

$4

441 claims · 0.0%

Your Cost: $0.01/claim|Median: $76.05
0.0× median
90853Normal range

Group psychotherapy

$0

17 claims · 0.0%

Your Cost: $0.00/claim|Median: $25.02