Is MERCY PLUS HEALTHCARE SERVICES LLC flagged for Medicaid fraud?

MERCY PLUS HEALTHCARE SERVICES LLC (NPI: 1669706149) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does MERCY PLUS HEALTHCARE SERVICES LLC bill Medicaid?

MERCY PLUS HEALTHCARE SERVICES LLC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Nursing Care provider. Located in FLUSHING, MI.

What is NPI 1669706149?

NPI 1669706149 is the National Provider Identifier for MERCY PLUS HEALTHCARE SERVICES LLC. They are a Nursing Care provider based in FLUSHING, MI. This NPI is registered with the CMS NPI Registry.

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MERCY PLUS HEALTHCARE SERVICES LLC

Nursing Care·FLUSHING, MI·NPI: 1669706149Share

Compared to Nursing Care Peers

Total spending distribution among 10 providers in this specialty

P25MedianP75P90

This provider's total spending of $49.6M is at the below 25th percentile among 10 Nursing Care providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$49.6M

$49,613,501

Total Claims

330K

Beneficiaries

26K

12.6 claims/patient

Avg Cost/Claim

$150

Monthly Spending Trend

Yearly Spending

2018

$3.9M

+36%

2019

$5.3M

-6%

2020

$5.0M

+13%

2021

$5.6M

+22%

2022

$6.8M

+52%

2023

$10.3M

+23%

2024

$12.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 18 distinct procedure codes. The top code (97153 (Adaptive behavior treatment by protocol, per 15 min)) accounts for 36% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

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

$18.0M

115K claims

$156.61

$167.38

0.9×

Normal range

97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$18.0M

115K claims · 36.4%

Your Cost: $156.61/claim|Median: $167.38

0.9× median

T1000Private duty/independent nursing service(s)See all providers →

$14.3M

44K claims

$325.79

$402.76

0.8×

Normal range

T1000Normal range

Private duty/independent nursing service(s)

$14.3M

44K claims · 28.8%

Your Cost: $325.79/claim|Median: $402.76

0.8× median

H2015Comprehensive community support services, per 15 minSee all providers →

$9.3M

111K claims

$83.78

$96.24

0.9×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$9.3M

111K claims · 18.7%

Your Cost: $83.78/claim|Median: $96.24

0.9× median

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

$5.8M

35K claims

$167.71

$146.45

1.1×

Normal range

97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$5.8M

35K claims · 11.7%

Your Cost: $167.71/claim|Median: $146.45

1.1× median

92507Speech/hearing/language treatmentSee all providers →

$923K

7,370 claims

$125.17

$49.45

2.5×

Top 5%

92507Top 5%

Speech/hearing/language treatment

$923K

7,370 claims · 1.9%

Your Cost: $125.17/claim|Median: $49.45

2.5× median

97151Behavior identification assessmentSee all providers →

$423K

909 claims

$465.27

$161.10

2.9×

Top 10%

97151Top 10%

Behavior identification assessment

$423K

909 claims · 0.9%

Your Cost: $465.27/claim|Median: $161.10

2.9× median

97530Therapeutic activities, each 15 minSee all providers →

$240K

2,985 claims

$80.28

$33.11

2.4×

Top 25%

97530Top 25%

Therapeutic activities, each 15 min

$240K

2,985 claims · 0.5%

Your Cost: $80.28/claim|Median: $33.11

2.4× median

97156 See all providers →

$232K

2,641 claims

$87.88

$88.65

1.0×

Normal range

97156Normal range

$232K

2,641 claims · 0.5%

Your Cost: $87.88/claim|Median: $88.65

1.0× median

S0215Non-invasive prenatal screening, fetal chromosomal abnormalitiesSee all providers →

$119K

9,079 claims

$13.15

$21.33

0.6×

Normal range

S0215Normal range

Non-invasive prenatal screening, fetal chromosomal abnormalities

$119K

9,079 claims · 0.2%

Your Cost: $13.15/claim|Median: $21.33

0.6× median

T1003LPN/LVN services, per 15 minutesSee all providers →

$81K

1,299 claims

$62.22

$24.24

2.6×

Normal range

T1003Normal range

LPN/LVN services, per 15 minutes

$81K

1,299 claims · 0.2%

Your Cost: $62.22/claim|Median: $24.24

2.6× median

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

$77K

423 claims

$182.94

$106.05

1.7×

Top 25%

0365TTop 25%

Adaptive behavior treatment, each additional thirty minutes

$77K

423 claims · 0.2%

Your Cost: $182.94/claim|Median: $106.05

1.7× median

0369T See all providers →

$17K

125 claims

$139.22

$102.36

1.4×

Normal range

0369TNormal range

$17K

125 claims · 0.0%

Your Cost: $139.22/claim|Median: $102.36

1.4× median

0364T See all providers →

$14K

442 claims

$31.11

$21.31

1.5×

Top 25%

0364TTop 25%

$14K

442 claims · 0.0%

Your Cost: $31.11/claim|Median: $21.31

1.5× median

0368T See all providers →

$8K

131 claims

$60.21

$44.63

1.3×

Top 25%

0368TTop 25%

$8K

131 claims · 0.0%

Your Cost: $60.21/claim|Median: $44.63

1.3× median

0359T See all providers →

$6K

13 claims

$480.00

$444.44

1.1×

Top 25%

0359TTop 25%

$6K

13 claims · 0.0%

Your Cost: $480.00/claim|Median: $444.44

1.1× median

H0032Mental health service plan developmentSee all providers →

$4K

30 claims

$123.33

$80.64

1.5×

Normal range

H0032Normal range

Mental health service plan development

$4K

30 claims · 0.0%

Your Cost: $123.33/claim|Median: $80.64

1.5× median

92523Evaluation of speech sound production with language comprehensionSee all providers →

$3K

15 claims

$218.17

$110.87

2.0×

Top 10%

92523Top 10%

Evaluation of speech sound production with language comprehension

$3K

15 claims · 0.0%

Your Cost: $218.17/claim|Median: $110.87

2.0× median

97535Self-care/home management training, per 15 minutesSee all providers →

$2K

55 claims

$37.47

$18.18

2.1×

Top 25%

97535Top 25%

Self-care/home management training, per 15 minutes

$2K

55 claims · 0.0%

Your Cost: $37.47/claim|Median: $18.18

2.1× median

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