Is ACORN HEALTH OF MICHIGAN, LLC flagged for Medicaid fraud?

ACORN HEALTH OF MICHIGAN, LLC (NPI: 1558841163) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does ACORN HEALTH OF MICHIGAN, LLC bill Medicaid?

ACORN HEALTH OF MICHIGAN, LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Behavior Analyst provider. Located in TRAVERSE CITY, MI.

What is NPI 1558841163?

NPI 1558841163 is the National Provider Identifier for ACORN HEALTH OF MICHIGAN, LLC. They are a Behavior Analyst provider based in TRAVERSE CITY, MI. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

ACORN HEALTH OF MICHIGAN, LLC

Behavior Analyst·TRAVERSE CITY, MI·NPI: 1558841163Share

Compared to Behavior Analyst Peers

Total spending distribution among 31 providers in this specialty

P25MedianP75P90

This provider's total spending of $61.0M is at the 75th percentile among 31 Behavior Analyst providers.

Active Billing Period:2018-10→2024-12(75 months)

Total Paid

$61.0M

$60,955,446

Total Claims

440K

Beneficiaries

53K

8.3 claims/patient

Avg Cost/Claim

$139

Monthly Spending Trend

Yearly Spending

2018

$735K

+464%

2019

$4.1M

+59%

2020

$6.6M

+46%

2021

$9.6M

+38%

2022

$13.2M

+7%

2023

$14.2M

-12%

2024

$12.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (97153 (Adaptive behavior treatment by protocol, per 15 min)) accounts for 69% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

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

$42.1M

289K claims

$145.75

$167.38

0.9×

Normal range

97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$42.1M

289K claims · 69.0%

Your Cost: $145.75/claim|Median: $167.38

0.9× median

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

$13.5M

100K claims

$134.97

$146.45

0.9×

Normal range

97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$13.5M

100K claims · 22.2%

Your Cost: $134.97/claim|Median: $146.45

0.9× median

97156 See all providers →

$2.5M

30K claims

$84.52

$88.65

1.0×

Normal range

97156Normal range

$2.5M

30K claims · 4.1%

Your Cost: $84.52/claim|Median: $88.65

1.0× median

97151Behavior identification assessmentSee all providers →

$1.9M

7,631 claims

$245.65

$161.10

1.5×

Top 25%

97151Top 25%

Behavior identification assessment

$1.9M

7,631 claims · 3.1%

Your Cost: $245.65/claim|Median: $161.10

1.5× median

0365TAdaptive behavior treatment, each additional thirty minutesSee all providers →

$396K

3,034 claims

$130.39

$106.05

1.2×

Normal range

0365TNormal range

Adaptive behavior treatment, each additional thirty minutes

$396K

3,034 claims · 0.6%

Your Cost: $130.39/claim|Median: $106.05

1.2× median

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

$203K

5,078 claims

$40.00

$55.95

0.7×

Normal range

97154Normal range

Group adaptive behavior treatment, per 15 min

$203K

5,078 claims · 0.3%

Your Cost: $40.00/claim|Median: $55.95

0.7× median

0369T See all providers →

$128K

1,044 claims

$122.71

$102.36

1.2×

Normal range

0369TNormal range

$128K

1,044 claims · 0.2%

Your Cost: $122.71/claim|Median: $102.36

1.2× median

0364T See all providers →

$71K

2,700 claims

$26.27

$21.31

1.2×

Normal range

0364TNormal range

$71K

2,700 claims · 0.1%

Your Cost: $26.27/claim|Median: $21.31

1.2× median

0368T See all providers →

$64K

1,127 claims

$57.09

$44.63

1.3×

Normal range

0368TNormal range

$64K

1,127 claims · 0.1%

Your Cost: $57.09/claim|Median: $44.63

1.3× median

0370T See all providers →

$43K

372 claims

$115.82

$88.49

1.3×

Normal range

0370TNormal range

$43K

372 claims · 0.1%

Your Cost: $115.82/claim|Median: $88.49

1.3× median

0359T See all providers →

$29K

66 claims

$441.31

$444.44

1.0×

Normal range

0359TNormal range

$29K

66 claims · 0.0%

Your Cost: $441.31/claim|Median: $444.44

1.0× median

H0032Mental health service plan developmentSee all providers →

$14K

110 claims

$123.73

$80.64

1.5×

Normal range

H0032Normal range

Mental health service plan development

$14K

110 claims · 0.0%

Your Cost: $123.73/claim|Median: $80.64

1.5× median

Other Top Providers in Michigan

View all →

Guardiantrac. LLC

Community/Behavioral Health

$2.68B

Centria Healthcare LLC

Home Health

$590.6M

Integra Partners LLC

Orthotic Fitter

$422.3M

Community Mental Health Authority of Clinton Eaton Ingham Counties

Clinic/Center Mental Health (Including Community

$368.4M

Macomb Oakland Regional Center Inc.

Community/Behavioral Health

$342.6M

Similar Providers

Other top providers in Behavior Analyst

California Psychcare, Inc.

Van Nuys, CA

$154.8M

Aware INC

Anaconda, MT

$140.4M

Gateway Pediatric Therapy LLC

Bingham Farms, MI

$124.9M

← All providers All providers in Michigan →How we detect fraud →