Behavioral Health Network INC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 4 procedure codes: H0037 at 7.7× median, T1012 at 7.5× 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:
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.
Risk Assessment
Bills $860.27 per claim for H2036 (Alcohol/drug treatment, per hour) — 3.4× the national median of $253.79.
Bills $1,732.83 per claim for H0037 (Community psychiatric supportive treatment program, per diem) — 7.7× the national median of $225.50.
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 $238.6M is at the 75th percentile among 28 Clinic/Center Mental Health (Including Community Mental Health Center) providers.
Total Paid
$238.6M
$238,591,774
Total Claims
2.4M
Beneficiaries
832K
2.9 claims/patient
Avg Cost/Claim
$99
#353 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Behavioral Health Network INC is a Clinic/Center Mental Health (Including Community Mental Health Center) provider based in Springfield, MA. From the 2018–2024 period, this provider received $238.6M in Medicaid payments across 2.4M claims.
Why This Matters
This provider received $238.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 29,823 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 (90834 (Psychotherapy, 45 minutes)) accounts for 15% of total spending.
Psychotherapy, 45 minutes
$35.4M
485K claims · 14.8%
$30.5M
141K claims
$215.87
$130.29
Medicaid certified CCBHC services
$30.5M
141K claims · 12.8%
$25.9M
46K claims
$557.85
$501.33
Crisis intervention mental health services, per diem
$25.9M
46K claims · 10.8%
$19.1M
116K claims
$164.21
$357.16
Behavioral health; residential, per diem
$19.1M
116K claims · 8.0%
$18.1M
125K claims
$145.11
$84.12
Therapeutic behavioral services, per 15 min
$18.1M
125K claims · 7.6%
$16.1M
315K claims
$51.10
$53.97
Behavioral health outreach service, per 15 minutes
$16.1M
315K claims · 6.8%
$8.9M
82K claims
$108.88
$53.00
Family training and counseling, per 15 minutes
$8.9M
82K claims · 3.7%
$8.1M
69K claims
$117.55
$96.24
Comprehensive community support services, per 15 min
$8.1M
69K claims · 3.4%
Psychotherapy, 60 minutes
$7.3M
87K claims · 3.1%
$7.3M
46K claims
$158.30
$215.80
Crisis intervention service, per 15 minutes
$7.3M
46K claims · 3.1%
$7.0M
48K claims
$146.29
$83.88
Skills training & development, per 15 min
$7.0M
48K claims · 2.9%
$6.8M
9K claims
$735.89
$317.54
Alcohol and/or drug services, acute detoxification, per diem
$6.8M
9K claims · 2.9%
$5.8M
9K claims
$658.74
$369.55
Alcohol and/or drug services, sub-acute detoxification, per diem
$5.8M
9K claims · 2.4%
$4.8M
86K claims
$55.85
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$4.8M
86K claims · 2.0%
$4.4M
272K claims
$16.25
$321.53
Comprehensive community support services, per 15 min
$4.4M
272K claims · 1.8%
Alcohol/drug treatment, per hour
$4.3M
5K claims · 1.8%
$3.5M
30K claims
$116.81
$266.41
Assertive community treatment, face-to-face, per 15 minutes
$3.5M
30K claims · 1.4%
$3.3M
19K claims
$177.58
$73.29
Medication-assisted treatment, opioid use disorder, per month
$3.3M
19K claims · 1.4%
Psychotherapy, 30 minutes
$2.8M
77K claims · 1.2%
$2.7M
20K claims
$133.20
$49.05
Nursing assessment/evaluation, per visit
$2.7M
20K claims · 1.1%
$2.2M
19K claims
$111.77
$99.21
Psychiatric diagnostic evaluation
$2.2M
19K claims · 0.9%
$1.5M
31K claims
$50.25
$47.55
Interpretation/explanation of results
$1.5M
31K claims · 0.6%
$1.4M
16K claims
$84.75
$55.04
Self-help/peer services, per 15 minutes
$1.4M
16K claims · 0.6%
$1.3M
74K claims
$17.75
$18.95
Alcohol/drug services; methadone administration
$1.3M
74K claims · 0.5%
$1.3M
11K claims
$120.42
$69.56
Targeted case management, per 15 min
$1.3M
11K claims · 0.5%
$1.3M
25K claims
$49.94
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$1.3M
25K claims · 0.5%
Environmental intervention
$1.2M
25K claims · 0.5%
$1.1M
5K claims
$222.98
$119.08
Evaluation & treatment, integrated specialty team
$1.1M
5K claims · 0.5%
$1.1M
644 claims
$1,732.83
$225.50
Community psychiatric supportive treatment program, per diem
$1.1M
644 claims · 0.5%
$752K
18K claims
$41.88
$85.02
Mental health services, not otherwise specified
$752K
18K claims · 0.3%
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