Mosaic
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $1,399.60 per claim for T2025 (Waiver services, NOS; per 15 min), which is 11.3× the national median of $124.39.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Compared to Community Based Residential Treatment Facility Mental Illness Peers
Total spending distribution among 6 providers in this specialty
This provider's total spending of $113.9M is at the 99th percentile among 6 Community Based Residential Treatment Facility Mental Illness providers.
Above 99th percentile for this specialty — higher spending than 5 of 6 peers
Total Paid
$113.9M
$113,910,966
Total Claims
0
Beneficiaries
0
Avg Cost/Claim
$0
🔍 Analysis
Provider Overview
Mosaic is a Community Based Residential Treatment Facility Mental Illness provider based in Newark, DE. From the 2018–2024 period, this provider received $0 in Medicaid payments across 0 claims.
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 3 distinct procedure codes. The top code (T2025 (Waiver services, NOS; per 15 min)) accounts for 100% of total spending.
Waiver services, NOS; per 15 min
$113.9M
81K claims · 100.0%
$2.3M
31K claims · 2.0%
Habilitation, residential, waiver; per diem
$2.3M
3K claims · 2.0%