Is CLARK COMMUNITY MENTAL HEALTH CENTER flagged for Medicaid fraud?

CLARK COMMUNITY MENTAL HEALTH CENTER (NPI: 1497297626) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does CLARK COMMUNITY MENTAL HEALTH CENTER bill Medicaid?

CLARK COMMUNITY MENTAL HEALTH CENTER received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in PIERCE CITY, MO.

What is NPI 1497297626?

NPI 1497297626 is the National Provider Identifier for CLARK COMMUNITY MENTAL HEALTH CENTER. They are a Community/Behavioral Health provider based in PIERCE CITY, MO. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

CLARK COMMUNITY MENTAL HEALTH CENTER

Community/Behavioral Health·PIERCE CITY, MO·NPI: 1497297626Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $68.8M is at the 50th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$68.8M

$68,752,445

Total Claims

522K

Beneficiaries

189K

2.8 claims/patient

Avg Cost/Claim

$132

Monthly Spending Trend

Yearly Spending

2018

$6.8M

+10%

2019

$7.5M

+21%

2020

$9.1M

+13%

2021

$10.2M

+1%

2022

$10.3M

+17%

2023

$12.0M

+6%

2024

$12.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 21 distinct procedure codes. The top code (T1040 (Medicaid certified CCBHC services)) accounts for 100% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1040Medicaid certified CCBHC servicesSee all providers →

$68.6M

250K claims

$274.02

$130.29

2.1×

Top 5%

T1040Top 5%

Medicaid certified CCBHC services

$68.6M

250K claims · 99.7%

Your Cost: $274.02/claim|Median: $130.29

2.1× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$63K

14K claims

$4.52

$37.81

0.1×

Normal range

99213Normal range

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

$63K

14K claims · 0.1%

Your Cost: $4.52/claim|Median: $37.81

0.1× median

90834Psychotherapy, 45 minutesSee all providers →

$46K

8,126 claims

$5.70

$63.65

0.1×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$46K

8,126 claims · 0.1%

Your Cost: $5.70/claim|Median: $63.65

0.1× median

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

$35K

2,724 claims

$12.72

$53.41

0.2×

Normal range

99214Normal range

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

$35K

2,724 claims · 0.1%

Your Cost: $12.72/claim|Median: $53.41

0.2× median

90832Psychotherapy, 30 minutesSee all providers →

$21K

4,795 claims

$4.33

$41.28

0.1×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$21K

4,795 claims · 0.0%

Your Cost: $4.33/claim|Median: $41.28

0.1× median

90837Psychotherapy, 60 minutesSee all providers →

$18K

329 claims

$54.32

$85.66

0.6×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$18K

329 claims · 0.0%

Your Cost: $54.32/claim|Median: $85.66

0.6× median

99212Office/outpatient visit, low complexitySee all providers →

$13K

3,935 claims

$3.21

$25.06

0.1×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$13K

3,935 claims · 0.0%

Your Cost: $3.21/claim|Median: $25.06

0.1× median

90791Psychiatric diagnostic evaluationSee all providers →

$1K

1,404 claims

$0.79

$99.21

0.0×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$1K

1,404 claims · 0.0%

Your Cost: $0.79/claim|Median: $99.21

0.0× median

99203Office/outpatient visit, new patient, low-mod complexitySee all providers →

35 claims

$0.00

$57.85

—

Normal range

99203Normal range

Office/outpatient visit, new patient, low-mod complexity

35 claims · 0.0%

Your Cost: $0.00/claim|Median: $57.85

99205Office/outpatient visit, new patient, high complexitySee all providers →

58 claims

$0.00

$111.09

—

Normal range

99205Normal range

Office/outpatient visit, new patient, high complexity

58 claims · 0.0%

Your Cost: $0.00/claim|Median: $111.09

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

4,654 claims

$0.00

$47.35

—

Normal range

H0005Normal range

Alcohol and/or drug services, group counseling

4,654 claims · 0.0%

Your Cost: $0.00/claim|Median: $47.35

H2015Comprehensive community support services, per 15 minSee all providers →

649 claims

$0.00

$96.24

—

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

649 claims · 0.0%

Your Cost: $0.00/claim|Median: $96.24

H0036Community psychiatric supportive treatment, per 15 minSee all providers →

154K claims

$0.00

$76.05

—

Normal range

H0036Normal range

Community psychiatric supportive treatment, per 15 min

154K claims · 0.0%

Your Cost: $0.00/claim|Median: $76.05

H0025Behavioral health prevention education, per sessionSee all providers →

2,333 claims

$0.00

$36.25

—

Normal range

H0025Normal range

Behavioral health prevention education, per session

2,333 claims · 0.0%

Your Cost: $0.00/claim|Median: $36.25

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

22K claims

$0.00

$55.04

—

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

22K claims · 0.0%

Your Cost: $0.00/claim|Median: $55.04

H0031Mental health assessment by non-physicianSee all providers →

112 claims

$0.00

$96.18

—

Normal range

H0031Normal range

Mental health assessment by non-physician

112 claims · 0.0%

Your Cost: $0.00/claim|Median: $96.18

99204Office/outpatient visit, new patient, mod-high complexitySee all providers →

19 claims

$0.00

$84.03

—

Normal range

99204Normal range

Office/outpatient visit, new patient, mod-high complexity

19 claims · 0.0%

Your Cost: $0.00/claim|Median: $84.03

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

34K claims

$0.00

$91.63

—

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

34K claims · 0.0%

Your Cost: $0.00/claim|Median: $91.63

H0004Behavioral health counseling & therapy, per 15 minSee all providers →

12K claims

$0.00

$74.63

—

Normal range

H0004Normal range

Behavioral health counseling & therapy, per 15 min

12K claims · 0.0%

Your Cost: $0.00/claim|Median: $74.63

H2010Comprehensive medication services, per 15 minSee all providers →

653 claims

$0.00

$62.69

—

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

653 claims · 0.0%

Your Cost: $0.00/claim|Median: $62.69

H0002Behavioral health screeningSee all providers →

7,353 claims

$0.00

$38.77

—

Normal range

H0002Normal range

Behavioral health screening

7,353 claims · 0.0%

Your Cost: $0.00/claim|Median: $38.77

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