Is LEGACY BEHAVIORAL HEALTH CENTER INC flagged for Medicaid fraud?

LEGACY BEHAVIORAL HEALTH CENTER INC (NPI: 1568439685) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does LEGACY BEHAVIORAL HEALTH CENTER INC bill Medicaid?

LEGACY BEHAVIORAL HEALTH CENTER INC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinic/Center, Mental Health (Including Community Mental Health Center) provider. Located in INDIANTOWN, FL.

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LEGACY BEHAVIORAL HEALTH CENTER INC

Clinic/Center, Mental Health (Including Community Mental Health Center)·INDIANTOWN, FL·NPI: 1568439685Share

Compared to Clinic/Center, Mental Health (Including Community Mental Health Center) Peers

Total spending distribution among 44 providers in this specialty

P25MedianP75P90

This provider's total spending of $44.8M is at the 50th percentile among 44 Clinic/Center, Mental Health (Including Community Mental Health Center) providers.

Active Billing Period:2018-02→2024-02(68 months)

Billing appears to have stoppedLast active: 2024-02

Total Paid

$44.8M

$44,812,762

Total Claims

737K

Beneficiaries

370K

2.0 claims/patient

Avg Cost/Claim

$61

Monthly Spending Trend

Yearly Spending

2018

$647K

+1434%

2019

$9.9M

+14%

2020

$11.3M

+16%

2021

$13.1M

-42%

2022

$7.6M

-71%

2023

$2.2M

-100%

2024

$9K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (H2019 (Therapeutic behavioral services, per 15 min)) accounts for 54% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H2019Therapeutic behavioral services, per 15 minSee all providers →

$24.1M

320K claims

$75.45

$84.12

0.9×

Normal range

H2019Normal range

Therapeutic behavioral services, per 15 min

$24.1M

320K claims · 53.8%

Your Cost: $75.45/claim|Median: $84.12

0.9× median

T1017Targeted case management, per 15 minSee all providers →

$9.6M

156K claims

$61.64

$69.56

0.9×

Normal range

T1017Normal range

Targeted case management, per 15 min

$9.6M

156K claims · 21.4%

Your Cost: $61.64/claim|Median: $69.56

0.9× median

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$3.9M

113K claims

$34.15

$121.16

0.3×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$3.9M

113K claims · 8.6%

Your Cost: $34.15/claim|Median: $121.16

0.3× median

H0032Mental health service plan developmentSee all providers →

$2.7M

47K claims

$58.61

$80.64

0.7×

Normal range

H0032Normal range

Mental health service plan development

$2.7M

47K claims · 6.1%

Your Cost: $58.61/claim|Median: $80.64

0.7× median

H2000Comprehensive multidisciplinary evaluationSee all providers →

$1.7M

9,991 claims

$174.62

$114.71

1.5×

Top 25%

H2000Top 25%

Comprehensive multidisciplinary evaluation

$1.7M

9,991 claims · 3.9%

Your Cost: $174.62/claim|Median: $114.71

1.5× median

H0031Mental health assessment by non-physicianSee all providers →

$1.6M

62K claims

$25.08

$96.18

0.3×

Normal range

H0031Normal range

Mental health assessment by non-physician

$1.6M

62K claims · 3.5%

Your Cost: $25.08/claim|Median: $96.18

0.3× median

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

$766K

12K claims

$61.78

$91.63

0.7×

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

$766K

12K claims · 1.7%

Your Cost: $61.78/claim|Median: $91.63

0.7× median

H2010Comprehensive medication services, per 15 minSee all providers →

$402K

16K claims

$25.74

$62.69

0.4×

Normal range

H2010Normal range

Comprehensive medication services, per 15 min

$402K

16K claims · 0.9%

Your Cost: $25.74/claim|Median: $62.69

0.4× median

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

$5K

1,017 claims

$5.07

$53.41

0.1×

Normal range

99214Normal range

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

$5K

1,017 claims · 0.0%

Your Cost: $5.07/claim|Median: $53.41

0.1× median

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

$730

342 claims

$2.13

$37.81

0.1×

Normal range

99213Normal range

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

$730

342 claims · 0.0%

Your Cost: $2.13/claim|Median: $37.81

0.1× median

96372Therapeutic injection, subcutaneous/intramuscularSee all providers →

$15

69 claims

$0.21

$9.56

0.0×

Normal range

96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$15

69 claims · 0.0%

Your Cost: $0.21/claim|Median: $9.56

0.0× median

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