Is ARIEL CLINICAL SERVICES flagged for Medicaid fraud?

ARIEL CLINICAL SERVICES (NPI: 1316306897) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ARIEL CLINICAL SERVICES bill Medicaid?

ARIEL CLINICAL SERVICES received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Day Training, Developmentally Disabled Services provider. Located in GRAND JUNCTION, CO.

What is NPI 1316306897?

NPI 1316306897 is the National Provider Identifier for ARIEL CLINICAL SERVICES. They are a Day Training, Developmentally Disabled Services provider based in GRAND JUNCTION, CO. This NPI is registered with the CMS NPI Registry.

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ARIEL CLINICAL SERVICES

Day Training, Developmentally Disabled Services·GRAND JUNCTION, CO·NPI: 1316306897Share

Compared to Day Training, Developmentally Disabled Services Peers

Total spending distribution among 56 providers in this specialty

P25MedianP75P90

This provider's total spending of $96.5M is at the 50th percentile among 56 Day Training, Developmentally Disabled Services providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$96.5M

$96,523,535

Total Claims

861K

Beneficiaries

53K

16.3 claims/patient

Avg Cost/Claim

$112

Monthly Spending Trend

Yearly Spending

2018

$11.3M

+7%

2019

$12.1M

+10%

2020

$13.3M

+7%

2021

$14.2M

+16%

2022

$16.5M

-2%

2023

$16.1M

-18%

2024

$13.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 19 distinct procedure codes. The top code (T2016 (Habilitation, residential, waiver; per diem)) accounts for 81% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2016Habilitation, residential, waiver; per diemSee all providers →

$78.5M

530K claims

$148.19

$331.94

0.4×

Normal range

T2016Normal range

Habilitation, residential, waiver; per diem

$78.5M

530K claims · 81.3%

Your Cost: $148.19/claim|Median: $331.94

0.4× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$10.8M

149K claims

$72.24

$150.51

0.5×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$10.8M

149K claims · 11.2%

Your Cost: $72.24/claim|Median: $150.51

0.5× median

T2003Non-emergency transport; encounter/tripSee all providers →

$2.0M

103K claims

$19.64

$21.70

0.9×

Normal range

T2003Normal range

Non-emergency transport; encounter/trip

$2.0M

103K claims · 2.1%

Your Cost: $19.64/claim|Median: $21.70

0.9× median

T2019Habilitation, prevocational, waiver; per 15 minSee all providers →

$1.9M

22K claims

$89.25

$88.91

1.0×

Normal range

T2019Normal range

Habilitation, prevocational, waiver; per 15 min

$1.9M

22K claims · 2.0%

Your Cost: $89.25/claim|Median: $88.91

1.0× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$1.2M

23K claims

$53.03

$84.12

0.6×

Normal range

H2019Normal range

Therapeutic behavioral services, per 15 min

$1.2M

23K claims · 1.3%

Your Cost: $53.03/claim|Median: $84.12

0.6× median

90837Psychotherapy, 60 minutesSee all providers →

$961K

9,543 claims

$100.68

$85.66

1.2×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$961K

9,543 claims · 1.0%

Your Cost: $100.68/claim|Median: $85.66

1.2× median

T2024Supported employment, waiver, per diemSee all providers →

$395K

4,790 claims

$82.51

$259.38

0.3×

Normal range

T2024Normal range

Supported employment, waiver, per diem

$395K

4,790 claims · 0.4%

Your Cost: $82.51/claim|Median: $259.38

0.3× median

S5150Unskilled respite care, per 15 minSee all providers →

$211K

2,928 claims

$72.03

$84.46

0.9×

Normal range

S5150Normal range

Unskilled respite care, per 15 min

$211K

2,928 claims · 0.2%

Your Cost: $72.03/claim|Median: $84.46

0.9× median

T2015Habilitation, prevocational, waiver, per diemSee all providers →

$196K

3,196 claims

$61.19

$88.27

0.7×

Normal range

T2015Normal range

Habilitation, prevocational, waiver, per diem

$196K

3,196 claims · 0.2%

Your Cost: $61.19/claim|Median: $88.27

0.7× median

H0041 See all providers →

$100K

631 claims

$158.15

$192.56

0.8×

Normal range

H0041Normal range

$100K

631 claims · 0.1%

Your Cost: $158.15/claim|Median: $192.56

0.8× median

H0032Mental health service plan developmentSee all providers →

$85K

1,648 claims

$51.52

$80.64

0.6×

Normal range

H0032Normal range

Mental health service plan development

$85K

1,648 claims · 0.1%

Your Cost: $51.52/claim|Median: $80.64

0.6× median

90834Psychotherapy, 45 minutesSee all providers →

$36K

486 claims

$73.44

$63.65

1.2×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$36K

486 claims · 0.0%

Your Cost: $73.44/claim|Median: $63.65

1.2× median

H2015Comprehensive community support services, per 15 minSee all providers →

$29K

147 claims

$195.09

$96.24

2.0×

Top 25%

H2015Top 25%

Comprehensive community support services, per 15 min

$29K

147 claims · 0.0%

Your Cost: $195.09/claim|Median: $96.24

2.0× median

T1017Targeted case management, per 15 minSee all providers →

$28K

772 claims

$36.50

$69.56

0.5×

Normal range

T1017Normal range

Targeted case management, per 15 min

$28K

772 claims · 0.0%

Your Cost: $36.50/claim|Median: $69.56

0.5× median

90791Psychiatric diagnostic evaluationSee all providers →

$25K

253 claims

$99.93

$99.21

1.0×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$25K

253 claims · 0.0%

Your Cost: $99.93/claim|Median: $99.21

1.0× median

T2004Non-emergency transportation, commercial carrier, encounter tripSee all providers →

$11K

6,570 claims

$1.72

$8.80

0.2×

Normal range

T2004Normal range

Non-emergency transportation, commercial carrier, encounter trip

$11K

6,570 claims · 0.0%

Your Cost: $1.72/claim|Median: $8.80

0.2× median

S5151Unskilled respite care, per diemSee all providers →

$11K

212 claims

$52.78

$249.18

0.2×

Normal range

S5151Normal range

Unskilled respite care, per diem

$11K

212 claims · 0.0%

Your Cost: $52.78/claim|Median: $249.18

0.2× median

90832Psychotherapy, 30 minutesSee all providers →

$2K

50 claims

$44.85

$41.28

1.1×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$2K

50 claims · 0.0%

Your Cost: $44.85/claim|Median: $41.28

1.1× median

T2034Crisis intervention, per 15 minSee all providers →

2,798 claims

$0.00

$254.45

—

Normal range

T2034Normal range

Crisis intervention, per 15 min

2,798 claims · 0.0%

Your Cost: $0.00/claim|Median: $254.45

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$362.5M

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