Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Bowen Health INC

Psychiatric Hospital·Warsaw, IN·NPI: 1639172810SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Bills $700.99 per claim for T2022 (Case management, per month) — 3.5× the national median of $202.77.

Billing above the 90th percentile for 2 procedure codes simultaneously.

This is a statistical summary, not an accusation. See our methodology.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$509.3M

$509,260,010

Total Claims

4.9M

Beneficiaries

1.8M

2.7 claims/patient

Avg Cost/Claim

$105

#118 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Bowen Health INC is a Psychiatric Hospital provider based in Warsaw, IN. From the 2018–2024 period, this provider received $509.3M in Medicaid payments across 4.9M claims.

Why This Matters

This provider received $509.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 63,657 Medicaid beneficiaries for a full year at average per-enrollee costs.

21% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$58.6M
+28%
2019
$75.2M
+14%
2020
$86.1M
+8%
2021
$92.9M
-11%
2022
$83.0M
-19%
2023
$67.3M
-32%
2024
$46.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (H2014 (Skills training & development, per 15 min)) accounts for 70% of total spending.

H2014Top 25%

Skills training & development, per 15 min

$355.4M

2.2M claims · 69.8%

Your Cost: $159.31/claim|Median: $83.88
1.9× median
90834Normal range

Psychotherapy, 45 minutes

$57.1M

753K claims · 11.2%

Your Cost: $75.79/claim|Median: $63.65
1.2× median
T1016Normal range

Case management, each 15 min

$19.9M

659K claims · 3.9%

Your Cost: $30.13/claim|Median: $49.62
0.6× median
90832Top 25%

Psychotherapy, 30 minutes

$17.3M

263K claims · 3.4%

Your Cost: $66.07/claim|Median: $41.28
1.6× median
99214Top 25%

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

$16.9M

219K claims · 3.3%

Your Cost: $77.37/claim|Median: $53.41
1.4× median
90791Normal range

Psychiatric diagnostic evaluation

$10.7M

119K claims · 2.1%

Your Cost: $90.04/claim|Median: $99.21
0.9× median
99213Top 25%

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

$8.8M

150K claims · 1.7%

Your Cost: $58.54/claim|Median: $37.81
1.6× median
90853Normal range

Group psychotherapy

$4.8M

152K claims · 0.9%

Your Cost: $31.84/claim|Median: $25.02
1.3× median
90837Normal range

Psychotherapy, 60 minutes

$4.2M

52K claims · 0.8%

Your Cost: $81.31/claim|Median: $85.66
0.9× median
90847Normal range

Family psychotherapy with patient, 50 min

$4.0M

72K claims · 0.8%

Your Cost: $55.97/claim|Median: $77.33
0.7× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$4.0M

45K claims · 0.8%

Your Cost: $89.80/claim|Median: $108.91
0.8× median
H0031Normal range

Mental health assessment by non-physician

$2.6M

45K claims · 0.5%

Your Cost: $56.83/claim|Median: $96.18
0.6× median
Q3014Top 5%

Telehealth originating site facility fee

$667K

18K claims · 0.1%

Your Cost: $36.77/claim|Median: $15.37
2.4× median
90846Normal range

Family psychotherapy without patient, 50 min

$629K

12K claims · 0.1%

Your Cost: $52.60/claim|Median: $76.61
0.7× median
T2022Top 5%

Case management, per month

$397K

567 claims · 0.1%

Your Cost: $700.99/claim|Median: $202.77
3.5× median
G0463Normal range

Hospital outpatient clinic visit

$355K

29K claims · 0.1%

Your Cost: $12.24/claim|Median: $26.41
0.5× median
H2011Normal range

Crisis intervention service, per 15 minutes

$308K

3K claims · 0.1%

Your Cost: $114.73/claim|Median: $215.80
0.5× median
99223Top 25%

Initial hospital care, per day, high complexity

$306K

3K claims · 0.1%

Your Cost: $104.05/claim|Median: $67.32
1.6× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$153K

13K claims · 0.0%

Your Cost: $11.50/claim|Median: $9.56
1.2× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$144K

4K claims · 0.0%

Your Cost: $37.05/claim|Median: $23.99
1.5× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$115K

3K claims · 0.0%

Your Cost: $36.81/claim|Median: $37.22
1.0× median
H0034Normal range

Medication training and management, per 15 min

$104K

2K claims · 0.0%

Your Cost: $47.02/claim|Median: $56.90
0.8× median
99231Normal range

Subsequent hospital care, per day, low complexity

$94K

5K claims · 0.0%

Your Cost: $18.83/claim|Median: $16.77
1.1× median
99212Top 25%

Office/outpatient visit, low complexity

$80K

2K claims · 0.0%

Your Cost: $44.89/claim|Median: $25.06
1.8× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$31K

522 claims · 0.0%

Your Cost: $58.53/claim|Median: $111.09
0.5× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$23K

1K claims · 0.0%

Your Cost: $20.95/claim|Median: $74.63
0.3× median
H0038Normal range

Self-help/peer services, per 15 minutes

$20K

1K claims · 0.0%

Your Cost: $17.97/claim|Median: $55.04
0.3× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$11K

136 claims · 0.0%

Your Cost: $81.63/claim|Median: $84.03
1.0× median
H2035Normal range

Alcohol and/or drug treatment, per hour

$10K

377 claims · 0.0%

Your Cost: $26.30/claim|Median: $94.63
0.3× median
99215Normal range

Office/outpatient visit, high complexity

$9K

93 claims · 0.0%

Your Cost: $92.16/claim|Median: $74.09
1.2× median