Is MAINSTREAM MENTAL HEALTH SERVICES, INC flagged for Medicaid fraud?

MAINSTREAM MENTAL HEALTH SERVICES, INC (NPI: 1700150166) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does MAINSTREAM MENTAL HEALTH SERVICES, INC bill Medicaid?

MAINSTREAM MENTAL HEALTH SERVICES, INC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Community/Behavioral Health provider. Located in DALEVILLE, VA.

What is NPI 1700150166?

NPI 1700150166 is the National Provider Identifier for MAINSTREAM MENTAL HEALTH SERVICES, INC. They are a Community/Behavioral Health provider based in DALEVILLE, VA. This NPI is registered with the CMS NPI Registry.

⚖️ Compare 🖨️ Print Report

MAINSTREAM MENTAL HEALTH SERVICES, INC

Community/Behavioral Health·DALEVILLE, VA·NPI: 1700150166Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $32.9M is at the 25th percentile among 218 Community/Behavioral Health providers.

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

Total Paid

$32.9M

$32,852,110

Total Claims

216K

Beneficiaries

29K

7.5 claims/patient

Avg Cost/Claim

$152

Monthly Spending Trend

Yearly Spending

2018

$2.7M

+7%

2019

$2.9M

+37%

2020

$3.9M

+41%

2021

$5.5M

+17%

2022

$6.5M

-7%

2023

$6.0M

-10%

2024

$5.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 12 distinct procedure codes. The top code (H0046 (Mental health services, not otherwise specified)) accounts for 81% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0046Mental health services, not otherwise specifiedSee all providers →

$26.6M

165K claims

$161.61

$85.02

1.9×

Normal range

H0046Normal range

Mental health services, not otherwise specified

$26.6M

165K claims · 80.9%

Your Cost: $161.61/claim|Median: $85.02

1.9× median

90837Psychotherapy, 60 minutesSee all providers →

$1.5M

16K claims

$93.83

$85.66

1.1×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$1.5M

16K claims · 4.7%

Your Cost: $93.83/claim|Median: $85.66

1.1× median

H2017Psychosocial rehabilitation services, per 15 minSee all providers →

$1.5M

23K claims

$64.32

$91.63

0.7×

Normal range

H2017Normal range

Psychosocial rehabilitation services, per 15 min

$1.5M

23K claims · 4.5%

Your Cost: $64.32/claim|Median: $91.63

0.7× median

H2011Crisis intervention service, per 15 minutesSee all providers →

$851K

781 claims

$1,089.17

$215.80

5.0×

Top 25%

H2011Top 25%

Crisis intervention service, per 15 minutes

$851K

781 claims · 2.6%

Your Cost: $1,089.17/claim|Median: $215.80

5.0× median

H2019Therapeutic behavioral services, per 15 minSee all providers →

$735K

1,653 claims

$444.60

$84.12

5.3×

Top 5%

H2019Top 5%

Therapeutic behavioral services, per 15 min

$735K

1,653 claims · 2.2%

Your Cost: $444.60/claim|Median: $84.12

5.3× median

S0201Partial hospitalization services, per diemSee all providers →

$570K

1,225 claims

$465.31

$445.16

1.0×

Normal range

S0201Normal range

Partial hospitalization services, per diem

$570K

1,225 claims · 1.7%

Your Cost: $465.31/claim|Median: $445.16

1.0× median

S9482Family stabilization services, per 15 minutesSee all providers →

$479K

748 claims

$640.26

$625.59

1.0×

Normal range

S9482Normal range

Family stabilization services, per 15 minutes

$479K

748 claims · 1.5%

Your Cost: $640.26/claim|Median: $625.59

1.0× median

H0032Mental health service plan developmentSee all providers →

$242K

2,934 claims

$82.33

$80.64

1.0×

Normal range

H0032Normal range

Mental health service plan development

$242K

2,934 claims · 0.7%

Your Cost: $82.33/claim|Median: $80.64

1.0× median

90832Psychotherapy, 30 minutesSee all providers →

$106K

2,202 claims

$48.06

$41.28

1.2×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$106K

2,202 claims · 0.3%

Your Cost: $48.06/claim|Median: $41.28

1.2× median

90834Psychotherapy, 45 minutesSee all providers →

$105K

1,624 claims

$64.54

$63.65

1.0×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$105K

1,624 claims · 0.3%

Your Cost: $64.54/claim|Median: $63.65

1.0× median

H0015Alcohol and/or drug abuse, intensive outpatient, per hourSee all providers →

$97K

402 claims

$240.05

$129.75

1.9×

Top 10%

H0015Top 10%

Alcohol and/or drug abuse, intensive outpatient, per hour

$97K

402 claims · 0.3%

Your Cost: $240.05/claim|Median: $129.75

1.9× median

90791Psychiatric diagnostic evaluationSee all providers →

$81K

729 claims

$110.72

$99.21

1.1×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$81K

729 claims · 0.2%

Your Cost: $110.72/claim|Median: $99.21

1.1× median

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