Mark Helms
Compared to Psychiatry & Neurology, Psychiatry Peers
Total spending distribution among 15 providers in this specialty
This provider's total spending of $175K is at the 50th percentile among 15 Psychiatry & Neurology, Psychiatry providers.
Total Paid
$175K
$175,089
Total Claims
3,466
Beneficiaries
1,489
2.3 claims/patient
Avg Cost/Claim
$51
🔍 Analysis
Provider Overview
Mark Helms is a Psychiatry & Neurology, Psychiatry provider based in Tucson, AZ. From 2018-01 through 2018-09, this provider received $175K in Medicaid payments across 3K claims serving 1K beneficiaries, billing 7 distinct procedure codes.
Key Findings
- 📊Bills 2.2× the national median for 99231 (99231), at $36 per claim vs. the median of $17, placing them above the 90th percentile.
- 📊Billing stopped in 2018-09, suggesting this provider is no longer active in Medicaid. Abrupt cessation of billing can be a risk indicator.
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 7 distinct procedure codes. The top code (99231 (Subsequent hospital care, per day, low complexity)) accounts for 52% of total spending.
$92K
2,526 claims
$36.30
$16.77
Subsequent hospital care, per day, low complexity
$92K
2,526 claims · 52.4%
$33K
204 claims
$163.88
$67.32
Initial hospital care, per day, high complexity
$33K
204 claims · 19.1%
$18K
291 claims
$60.63
$37.22
Hospital discharge day management, 30 minutes or less
$18K
291 claims · 10.1%
$15K
224 claims
$65.57
$23.99
Subsequent hospital care, per day, moderate complexity
$15K
224 claims · 8.4%
$7K
90 claims
$75.55
$43.85
Hospital discharge day management, more than 30 minutes
$7K
90 claims · 3.9%
$7K
96 claims
$67.75
$39.96
Initial hospital care, straightforward/low
$7K
96 claims · 3.7%
$4K
35 claims
$123.59
$51.25
Initial hospital care, per day, moderate complexity
$4K
35 claims · 2.5%
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