Is NEW HORIZON CARE CENTER, INC. flagged for Medicaid fraud?

NEW HORIZON CARE CENTER, INC. (NPI: 1538388665) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does NEW HORIZON CARE CENTER, INC. bill Medicaid?

NEW HORIZON CARE CENTER, 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 SPOKANE, WA.

What is NPI 1538388665?

NPI 1538388665 is the National Provider Identifier for NEW HORIZON CARE CENTER, INC.. They are a Substance Abuse Rehabilitation Facility provider based in SPOKANE, WA. This NPI is registered with the CMS NPI Registry.

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NEW HORIZON CARE CENTER, INC.

Substance Abuse Rehabilitation Facility·SPOKANE, WA·NPI: 1538388665Share

Compared to Substance Abuse Rehabilitation Facility Peers

Total spending distribution among 20 providers in this specialty

P25MedianP75P90

This provider's total spending of $20.2M is at the 25th percentile among 20 Substance Abuse Rehabilitation Facility providers.

Active Billing Period:2018-01→2024-11(81 months)

Total Paid

$20.2M

$20,209,556

Total Claims

26K

Beneficiaries

13K

1.9 claims/patient

Avg Cost/Claim

$789

Monthly Spending Trend

Yearly Spending

2018

$253K

+439%

2019

$1.4M

+68%

2020

$2.3M

+31%

2021

$3.0M

+19%

2022

$3.6M

+20%

2023

$4.3M

+24%

2024

$5.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (H0018 (Behavioral health; short-term residential, per diem)) accounts for 45% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

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

$9.0M

4,393 claims

$2,055.85

$467.51

4.4×

Top 25%

H0018Top 25%

Behavioral health; short-term residential, per diem

$9.0M

4,393 claims · 44.7%

Your Cost: $2,055.85/claim|Median: $467.51

4.4× median

H0019Behavioral health; residential, per diemSee all providers →

$8.8M

6,377 claims

$1,376.33

$357.16

3.9×

Top 25%

H0019Top 25%

Behavioral health; residential, per diem

$8.8M

6,377 claims · 43.4%

Your Cost: $1,376.33/claim|Median: $357.16

3.9× median

T1009 See all providers →

$1.0M

3,241 claims

$311.78

$74.83

4.2×

Top 1%

T1009Top 1%

$1.0M

3,241 claims · 5.0%

Your Cost: $311.78/claim|Median: $74.83

4.2× median

H2036Alcohol/drug treatment, per hourSee all providers →

$984K

5,441 claims

$180.91

$253.79

0.7×

Normal range

H2036Normal range

Alcohol/drug treatment, per hour

$984K

5,441 claims · 4.9%

Your Cost: $180.91/claim|Median: $253.79

0.7× median

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

$159K

3,010 claims

$52.96

$37.81

1.4×

Normal range

99213Normal range

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

$159K

3,010 claims · 0.8%

Your Cost: $52.96/claim|Median: $37.81

1.4× median

H0043Supported housing, per diemSee all providers →

$156K

1,402 claims

$111.35

$164.87

0.7×

Normal range

H0043Normal range

Supported housing, per diem

$156K

1,402 claims · 0.8%

Your Cost: $111.35/claim|Median: $164.87

0.7× median

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

$69K

875 claims

$78.34

$53.41

1.5×

Top 25%

99214Top 25%

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

$69K

875 claims · 0.3%

Your Cost: $78.34/claim|Median: $53.41

1.5× median

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

$17K

676 claims

$25.39

$55.04

0.5×

Normal range

H0038Normal range

Self-help/peer services, per 15 minutes

$17K

676 claims · 0.1%

Your Cost: $25.39/claim|Median: $55.04

0.5× median

99212Office/outpatient visit, low complexitySee all providers →

$5K

155 claims

$30.86

$25.06

1.2×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$5K

155 claims · 0.0%

Your Cost: $30.86/claim|Median: $25.06

1.2× median

99211Office/outpatient visit, minimal complexitySee all providers →

$289

23 claims

$12.57

$12.93

1.0×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$289

23 claims · 0.0%

Your Cost: $12.57/claim|Median: $12.93

1.0× median

96372Therapeutic injection, subcutaneous/intramuscularSee all providers →

$186

12 claims

$15.46

$9.56

1.6×

Top 25%

96372Top 25%

Therapeutic injection, subcutaneous/intramuscular

$186

12 claims · 0.0%

Your Cost: $15.46/claim|Median: $9.56

1.6× median

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