Is HEALTHCALL OF DETROIT flagged for Medicaid fraud?

HEALTHCALL OF DETROIT (NPI: 1497760086) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does HEALTHCALL OF DETROIT bill Medicaid?

HEALTHCALL OF DETROIT received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Nursing Care provider. Located in ROYAL OAK, MI.

What is NPI 1497760086?

NPI 1497760086 is the National Provider Identifier for HEALTHCALL OF DETROIT. They are a Nursing Care provider based in ROYAL OAK, MI. This NPI is registered with the CMS NPI Registry.

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HEALTHCALL OF DETROIT

Nursing Care·ROYAL OAK, MI·NPI: 1497760086Share

Compared to Nursing Care Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $32.9M is at the below 25th percentile among 10 Nursing Care providers.

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

Total Paid

$32.9M

$32,851,437

Total Claims

124K

Beneficiaries

10K

12.1 claims/patient

Avg Cost/Claim

$264

Monthly Spending Trend

Yearly Spending

2018

$4.2M

-7%

2019

$3.9M

-5%

2020

$3.7M

+35%

2021

$5.0M

-1%

2022

$4.9M

+28%

2023

$6.3M

-22%

2024

$5.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (T1000 (Private duty/independent nursing service(s))) accounts for 66% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1000Private duty/independent nursing service(s)See all providers →

$21.6M

53K claims

$408.55

$402.76

1.0×

Normal range

T1000Normal range

Private duty/independent nursing service(s)

$21.6M

53K claims · 65.6%

Your Cost: $408.55/claim|Median: $402.76

1.0× median

97153Adaptive behavior treatment by protocol, per 15 minSee all providers →

$7.0M

40K claims

$174.97

$167.38

1.0×

Normal range

97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$7.0M

40K claims · 21.4%

Your Cost: $174.97/claim|Median: $167.38

1.0× median

S9123Nursing care, in the home, by RN, per 15 minutesSee all providers →

$1.5M

3,735 claims

$403.39

$124.86

3.2×

Top 25%

S9123Top 25%

Nursing care, in the home, by RN, per 15 minutes

$1.5M

3,735 claims · 4.6%

Your Cost: $403.39/claim|Median: $124.86

3.2× median

97155Adaptive behavior treatment with protocol modification, per 15 minutesSee all providers →

$1.4M

12K claims

$122.08

$146.45

0.8×

Normal range

97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$1.4M

12K claims · 4.3%

Your Cost: $122.08/claim|Median: $146.45

0.8× median

97154Group adaptive behavior treatment, per 15 minSee all providers →

$572K

10K claims

$55.99

$55.95

1.0×

Normal range

97154Normal range

Group adaptive behavior treatment, per 15 min

$572K

10K claims · 1.7%

Your Cost: $55.99/claim|Median: $55.95

1.0× median

90791Psychiatric diagnostic evaluationSee all providers →

$187K

523 claims

$358.08

$99.21

3.6×

Top 1%

90791Top 1%

Psychiatric diagnostic evaluation

$187K

523 claims · 0.6%

Your Cost: $358.08/claim|Median: $99.21

3.6× median

H0031Mental health assessment by non-physicianSee all providers →

$151K

774 claims

$194.46

$96.18

2.0×

Top 25%

H0031Top 25%

Mental health assessment by non-physician

$151K

774 claims · 0.5%

Your Cost: $194.46/claim|Median: $96.18

2.0× median

97156 See all providers →

$102K

1,505 claims

$68.10

$88.65

0.8×

Normal range

97156Normal range

$102K

1,505 claims · 0.3%

Your Cost: $68.10/claim|Median: $88.65

0.8× median

T1005Respite care services, per 15 minutesSee all providers →

$101K

396 claims

$255.66

$71.40

3.6×

Top 10%

T1005Top 10%

Respite care services, per 15 minutes

$101K

396 claims · 0.3%

Your Cost: $255.66/claim|Median: $71.40

3.6× median

97151Behavior identification assessmentSee all providers →

$96K

132 claims

$727.11

$161.10

4.5×

Top 5%

97151Top 5%

Behavior identification assessment

$96K

132 claims · 0.3%

Your Cost: $727.11/claim|Median: $161.10

4.5× median

92507Speech/hearing/language treatmentSee all providers →

$89K

1,738 claims

$51.35

$49.45

1.0×

Normal range

92507Normal range

Speech/hearing/language treatment

$89K

1,738 claims · 0.3%

Your Cost: $51.35/claim|Median: $49.45

1.0× median

97530Therapeutic activities, each 15 minSee all providers →

$37K

655 claims

$56.03

$33.11

1.7×

Normal range

97530Normal range

Therapeutic activities, each 15 min

$37K

655 claims · 0.1%

Your Cost: $56.03/claim|Median: $33.11

1.7× median

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