Youth Villages Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $12,565.74 per claim for T2016 (Habilitation, residential, waiver; per diem), which is 37.9× the national median of $331.94.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 11 procedure codes: T2048 at 10.8× median, H0036 at 7.1× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
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.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
Unusually High Spending
Unusually High Spending means this provider's total Medicaid payments are significantly above the median for their specialty. This doesn't necessarily indicate fraud — high volume practices and those serving complex populations may legitimately bill more.
High Cost Per Claim
High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $15,498.18 per claim for T2048 (Behavioral health; long-term residential, per diem) — 10.8× the national median of $1,437.23.
Bills $540.78 per claim for H0036 (Community psychiatric supportive treatment, per 15 min) — 7.1× the national median of $76.05.
Bills $12,565.74 per claim for T2016 (Habilitation, residential, waiver; per diem) — 37.9× the national median of $331.94.
Billing in the top 1% nationally for 6 procedure codes: H0036, T2016, H0032.
This is a statistical summary, not an accusation. See our methodology.
Compared to Community/Behavioral Health Peers
Total spending distribution among 218 providers in this specialty
This provider's total spending of $615.3M is at the 90th percentile among 218 Community/Behavioral Health providers.
Above 90th percentile for this specialty — higher spending than 196 of 218 peers
Total Paid
$615.3M
$615,308,760
Total Claims
791K
Beneficiaries
216K
3.7 claims/patient
Avg Cost/Claim
$778
#87 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Youth Villages Inc. is a Community/Behavioral Health provider based in Bartlett, TN. From the 2018–2024 period, this provider received $615.3M in Medicaid payments across 791K claims.
Why This Matters
This provider received $615.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 76,913 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 30 distinct procedure codes. The top code (T2048 (Behavioral health; long-term residential, per diem)) accounts for 30% of total spending.
$183.2M
12K claims
$15,498.18
$1,437.23
Behavioral health; long-term residential, per diem
$183.2M
12K claims · 29.8%
$118.8M
390K claims
$304.90
$225.50
Community psychiatric supportive treatment program, per diem
$118.8M
390K claims · 19.3%
$74.7M
138K claims
$540.78
$76.05
Community psychiatric supportive treatment, per 15 min
$74.7M
138K claims · 12.1%
$63.3M
5K claims
$12,565.74
$331.94
Habilitation, residential, waiver; per diem
$63.3M
5K claims · 10.3%
$49.7M
14K claims
$3,473.44
$357.16
Behavioral health; residential, per diem
$49.7M
14K claims · 8.1%
$32.3M
17K claims
$1,953.35
$144.05
Day habilitation, waiver, per 15 minutes
$32.3M
17K claims · 5.2%
$24.3M
54K claims
$452.14
$227.82
Multisystemic therapy for juveniles, per 15 minutes
$24.3M
54K claims · 3.9%
$18.5M
17K claims
$1,065.42
$336.31
Community-based wrap-around services, per diem
$18.5M
17K claims · 3.0%
$15.3M
16K claims
$958.37
$300.13
Community transition, waiver; per service
$15.3M
16K claims · 2.5%
$9.2M
21K claims
$445.60
$80.64
Mental health service plan development
$9.2M
21K claims · 1.5%
$7.0M
3K claims
$2,231.21
$266.41
Assertive community treatment, face-to-face, per 15 minutes
$7.0M
3K claims · 1.1%
$5.5M
4K claims
$1,573.94
$321.53
Comprehensive community support services, per 15 min
$5.5M
4K claims · 0.9%
$3.9M
6K claims
$653.30
$216.31
Foster care, therapeutic, child, per diem
$3.9M
6K claims · 0.6%
$3.2M
945 claims
$3,384.86
$135.70
Intensive outpatient psychiatric services, per diem
$3.2M
945 claims · 0.5%
$2.0M
21K claims
$94.10
$227.80
Waiver services, NOS, per 15 minutes
$2.0M
21K claims · 0.3%
$995K
9K claims
$105.96
$84.12
Therapeutic behavioral services, per 15 min
$995K
9K claims · 0.2%
Psychiatric diagnostic evaluation
$963K
6K claims · 0.2%
$888K
308 claims
$2,883.76
$53.97
Behavioral health outreach service, per 15 minutes
$888K
308 claims · 0.1%
$546K
7K claims
$75.70
$169.11
Community-based wrap-around services, per 15 min
$546K
7K claims · 0.1%
$347K
30K claims
$11.52
$215.80
Crisis intervention service, per 15 minutes
$347K
30K claims · 0.1%
$267K
5K claims
$51.99
$96.18
Mental health assessment by non-physician
$267K
5K claims · 0.0%
$133K
7K claims
$20.46
$137.86
Behavioral health day treatment, per hour
$133K
7K claims · 0.0%
Psychotherapy, 60 minutes
$107K
4K claims · 0.0%
$93K
1K claims
$64.13
$53.00
Family training and counseling, per 15 minutes
$93K
1K claims · 0.0%
$50K
2K claims
$31.88
$77.33
Family psychotherapy with patient, 50 min
$50K
2K claims · 0.0%
$26K
440 claims
$58.35
$96.24
Comprehensive community support services, per 15 min
$26K
440 claims · 0.0%
$14K
473 claims
$30.30
$76.61
Family psychotherapy without patient, 50 min
$14K
473 claims · 0.0%
$2K
36 claims
$61.23
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$2K
36 claims · 0.0%
$2K
12 claims
$125.20
$84.03
Office/outpatient visit, new patient, mod-high complexity
$2K
12 claims · 0.0%
$1K
16 claims
$93.35
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$1K
16 claims · 0.0%
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