New Horizon Counseling Center INC
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $12.6M (2019) to $46.7M (2020) — a 271% swing with $34.2M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 6 procedure codes: 90832 at 2.4× median, 99213 at 2.4× median.
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:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
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.
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 $1,619.84 per claim for H0040 (Assertive community treatment, face-to-face, per 15 minutes) — 6.1× the national median of $266.41.
Bills $88.33 per claim for 90853 (Group psychotherapy) — 3.5× the national median of $25.02.
Bills $67.21 per claim for 99401 — 4.1× the national median of $16.53.
Billing in the top 1% nationally for 1 procedure code: 99401.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center Mental Health (Including Community Mental Health Center) Peers
Total spending distribution among 28 providers in this specialty
This provider's total spending of $213.1M is at the 50th percentile among 28 Clinic/Center Mental Health (Including Community Mental Health Center) providers.
Total Paid
$213.1M
$213,090,355
Total Claims
2.3M
Beneficiaries
665K
3.5 claims/patient
Avg Cost/Claim
$91
#413 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
New Horizon Counseling Center INC is a Clinic/Center Mental Health (Including Community Mental Health Center) provider based in South Ozone Park, NY. From the 2018–2024 period, this provider received $213.1M in Medicaid payments across 2.3M claims.
Why This Matters
This provider received $213.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,636 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 27 distinct procedure codes. The top code (90832 (Psychotherapy, 30 minutes)) accounts for 58% of total spending.
Psychotherapy, 30 minutes
$124.4M
1.3M claims · 58.4%
$26.1M
282K claims
$92.51
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$26.1M
282K claims · 12.3%
$18.6M
176K claims
$105.72
$130.29
Medicaid certified CCBHC services
$18.6M
176K claims · 8.7%
$7.8M
151K claims
$51.53
$137.86
Behavioral health day treatment, per hour
$7.8M
151K claims · 3.6%
$7.1M
70K claims
$102.64
$76.61
Family psychotherapy without patient, 50 min
$7.1M
70K claims · 3.4%
Psychotherapy, 45 minutes
$5.5M
44K claims · 2.6%
$3.5M
2K claims
$1,619.84
$266.41
Assertive community treatment, face-to-face, per 15 minutes
$3.5M
2K claims · 1.6%
Psychiatric diagnostic evaluation
$3.2M
23K claims · 1.5%
Group psychotherapy
$3.2M
36K claims · 1.5%
$2.9M
43K claims · 1.4%
$2.2M
12K claims
$176.91
$108.91
Psychiatric diagnostic evaluation with medical services
$2.2M
12K claims · 1.0%
$2.2M
33K claims
$65.57
$215.80
Crisis intervention service, per 15 minutes
$2.2M
33K claims · 1.0%
$1.8M
143K claims · 0.9%
$1.5M
17K claims
$85.73
$91.63
Psychosocial rehabilitation services, per 15 min
$1.5M
17K claims · 0.7%
$1.2M
26K claims
$47.43
$83.88
Skills training & development, per 15 min
$1.2M
26K claims · 0.6%
$751K
8K claims
$97.26
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$751K
8K claims · 0.4%
$633K
12K claims
$51.38
$55.04
Self-help/peer services, per 15 minutes
$633K
12K claims · 0.3%
Case management, each 15 min
$263K
4K claims · 0.1%
$133K
6K claims
$22.43
$9.56
Therapeutic injection, subcutaneous/intramuscular
$133K
6K claims · 0.1%
$54K
855 claims
$62.88
$38.83
Psychotherapy, 30 min, add-on to E/M service
$54K
855 claims · 0.0%
$49K
256 claims
$190.63
$77.33
Family psychotherapy with patient, 50 min
$49K
256 claims · 0.0%
$44K
655 claims
$67.14
$62.69
Comprehensive medication services, per 15 min
$44K
655 claims · 0.0%
$42K
867 claims
$48.69
$74.63
Behavioral health counseling & therapy, per 15 min
$42K
867 claims · 0.0%
Psychotherapy for crisis, first 60 min
$2K
16 claims · 0.0%
$2K
62 claims
$32.62
$32.55
Telephone E/M by physician, 21-30 min
$2K
62 claims · 0.0%
$662
73 claims
$9.06
$22.44
Telephone E/M by physician, 11-20 minutes
$662
73 claims · 0.0%
$0
18 claims
$0.00
$67.32
Initial hospital care, per day, high complexity
$0
18 claims · 0.0%
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