Youth Villages Inc.
Community/Behavioral Health
Bartlett, Tennessee
NPI: 1306875695
Risk Tier
Critical
Total Paid
$615.3M
$615,308,760
Total Claims
791K
Beneficiaries
216K
Avg Cost/Claim
$777.94
Active billing period: 83 months (2018-01 to 2024-11)
Statistical Fraud Flags (4)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
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.
Advanced Detection Signals
CUSUM Change Point
Billing shifted 3.5x in 2021-06 — a statistically significant structural change in billing behavior was detected.
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