Is ELMHURST HOME, INC. flagged for Medicaid fraud?

ELMHURST HOME, INC. (NPI: 1366659906) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ELMHURST HOME, INC. bill Medicaid?

ELMHURST HOME, INC. received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Substance Abuse Rehabilitation Facility provider. Located in DETROIT, MI.

What is NPI 1366659906?

NPI 1366659906 is the National Provider Identifier for ELMHURST HOME, INC.. They are a Substance Abuse Rehabilitation Facility provider based in DETROIT, MI. This NPI is registered with the CMS NPI Registry.

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ELMHURST HOME, INC.

Substance Abuse Rehabilitation Facility·DETROIT, MI·NPI: 1366659906Share

Compared to Substance Abuse Rehabilitation Facility Peers

Total spending distribution among 20 providers in this specialty

P25MedianP75P90

This provider's total spending of $21.4M is at the 25th percentile among 20 Substance Abuse Rehabilitation Facility providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$21.4M

$21,382,140

Total Claims

185K

Beneficiaries

37K

5.0 claims/patient

Avg Cost/Claim

$116

Monthly Spending Trend

Yearly Spending

2018

$3.3M

-21%

2019

$2.6M

-4%

2020

$2.5M

-3%

2021

$2.4M

+4%

2022

$2.5M

+44%

2023

$3.6M

+26%

2024

$4.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 22 distinct procedure codes. The top code (H0018 (Behavioral health; short-term residential, per diem)) accounts for 52% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0018Behavioral health; short-term residential, per diemSee all providers →

$11.1M

18K claims

$621.95

$467.51

1.3×

Normal range

H0018Normal range

Behavioral health; short-term residential, per diem

$11.1M

18K claims · 52.0%

Your Cost: $621.95/claim|Median: $467.51

1.3× median

S9976 See all providers →

$3.3M

34K claims

$94.90

$64.43

1.5×

Normal range

S9976Normal range

$3.3M

34K claims · 15.2%

Your Cost: $94.90/claim|Median: $64.43

1.5× median

T1012Alcohol/drug services, skills developmentSee all providers →

$1.7M

28K claims

$61.55

$40.78

1.5×

Normal range

T1012Normal range

Alcohol/drug services, skills development

$1.7M

28K claims · 7.9%

Your Cost: $61.55/claim|Median: $40.78

1.5× median

H0023Behavioral health outreach service, per 15 minutesSee all providers →

$1.1M

18K claims

$63.11

$53.97

1.2×

Normal range

H0023Normal range

Behavioral health outreach service, per 15 minutes

$1.1M

18K claims · 5.3%

Your Cost: $63.11/claim|Median: $53.97

1.2× median

H0015Alcohol and/or drug abuse, intensive outpatient, per hourSee all providers →

$1.1M

11K claims

$95.42

$129.75

0.7×

Normal range

H0015Normal range

Alcohol and/or drug abuse, intensive outpatient, per hour

$1.1M

11K claims · 5.0%

Your Cost: $95.42/claim|Median: $129.75

0.7× median

H0038Self-help/peer services, per 15 minutesSee all providers →

$976K

29K claims

$33.36

$55.04

0.6×

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

$976K

29K claims · 4.6%

Your Cost: $33.36/claim|Median: $55.04

0.6× median

H2034Alcohol and/or drug abuse halfway house services, per hourSee all providers →

$717K

5,010 claims

$143.05

$164.03

0.9×

Normal range

H2034Normal range

Alcohol and/or drug abuse halfway house services, per hour

$717K

5,010 claims · 3.4%

Your Cost: $143.05/claim|Median: $164.03

0.9× median

H0019Behavioral health; residential, per diemSee all providers →

$504K

5,147 claims

$98.00

$357.16

0.3×

Normal range

H0019Normal range

Behavioral health; residential, per diem

$504K

5,147 claims · 2.4%

Your Cost: $98.00/claim|Median: $357.16

0.3× median

H0001Alcohol and/or drug assessmentSee all providers →

$359K

2,904 claims

$123.74

$94.22

1.3×

Normal range

H0001Normal range

Alcohol and/or drug assessment

$359K

2,904 claims · 1.7%

Your Cost: $123.74/claim|Median: $94.22

1.3× median

H0006Alcohol and/or drug services, case managementSee all providers →

$297K

3,708 claims

$80.11

$43.10

1.9×

Top 25%

H0006Top 25%

Alcohol and/or drug services, case management

$297K

3,708 claims · 1.4%

Your Cost: $80.11/claim|Median: $43.10

1.9× median

90837Psychotherapy, 60 minutesSee all providers →

$124K

889 claims

$139.83

$85.66

1.6×

Top 10%

90837Top 10%

Psychotherapy, 60 minutes

$124K

889 claims · 0.6%

Your Cost: $139.83/claim|Median: $85.66

1.6× median

H0031Mental health assessment by non-physicianSee all providers →

$38K

348 claims

$109.19

$96.18

1.1×

Normal range

H0031Normal range

Mental health assessment by non-physician

$38K

348 claims · 0.2%

Your Cost: $109.19/claim|Median: $96.18

1.1× median

99215Office/outpatient visit, high complexitySee all providers →

$25K

201 claims

$126.43

$74.09

1.7×

Top 25%

99215Top 25%

Office/outpatient visit, high complexity

$25K

201 claims · 0.1%

Your Cost: $126.43/claim|Median: $74.09

1.7× median

H0032Mental health service plan developmentSee all providers →

$24K

183 claims

$132.01

$80.64

1.6×

Top 25%

H0032Top 25%

Mental health service plan development

$24K

183 claims · 0.1%

Your Cost: $132.01/claim|Median: $80.64

1.6× median

T1017Targeted case management, per 15 minSee all providers →

$19K

339 claims

$54.76

$69.56

0.8×

Normal range

T1017Normal range

Targeted case management, per 15 min

$19K

339 claims · 0.1%

Your Cost: $54.76/claim|Median: $69.56

0.8× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$9K

90 claims

$101.06

$53.41

1.9×

Top 10%

99214Top 10%

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

$9K

90 claims · 0.0%

Your Cost: $101.06/claim|Median: $53.41

1.9× median

90853Group psychotherapySee all providers →

$7K

251 claims

$28.96

$25.02

1.2×

Normal range

90853Normal range

Group psychotherapy

$7K

251 claims · 0.0%

Your Cost: $28.96/claim|Median: $25.02

1.2× median

T1001Nursing assessment/evaluation, per visitSee all providers →

$5K

49 claims

$94.51

$49.05

1.9×

Top 25%

T1001Top 25%

Nursing assessment/evaluation, per visit

$5K

49 claims · 0.0%

Your Cost: $94.51/claim|Median: $49.05

1.9× median

90791Psychiatric diagnostic evaluationSee all providers →

$4K

27 claims

$161.70

$99.21

1.6×

Top 25%

90791Top 25%

Psychiatric diagnostic evaluation

$4K

27 claims · 0.0%

Your Cost: $161.70/claim|Median: $99.21

1.6× median

H0005Alcohol and/or drug services, group counselingSee all providers →

$2K

90 claims

$24.97

$47.35

0.5×

Normal range

H0005Normal range

Alcohol and/or drug services, group counseling

$2K

90 claims · 0.0%

Your Cost: $24.97/claim|Median: $47.35

0.5× median

90832Psychotherapy, 30 minutesSee all providers →

$2K

33 claims

$56.47

$41.28

1.4×

Top 25%

90832Top 25%

Psychotherapy, 30 minutes

$2K

33 claims · 0.0%

Your Cost: $56.47/claim|Median: $41.28

1.4× median

T1040Medicaid certified CCBHC servicesSee all providers →

$273

27K claims

$0.01

$130.29

0.0×

Normal range

T1040Normal range

Medicaid certified CCBHC services

$273

27K claims · 0.0%

Your Cost: $0.01/claim|Median: $130.29

0.0× median

Other Top Providers in Michigan

View all →

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$2.68B

Centria Healthcare LLC

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$590.6M

Integra Partners LLC

Orthotic Fitter

$422.3M

Community Mental Health Authority of Clinton Eaton Ingham Counties

Clinic/Center Mental Health (Including Community

$368.4M

Macomb Oakland Regional Center Inc.

Community/Behavioral Health

$342.6M

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Minneapolis, MN

$200.3M

Samaritan Daytop Village Inc.

Richmond Hill, NY

$191.8M

Helio Health Inc.

Syracuse, NY

$162.9M

Pyramid Health Care Inc.

Wilkinsburg, PA

$128.8M

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