County of Fresno
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $1,781.62 per claim for S9484 (Crisis intervention mental health services, per hour), which is 7.1× the national median of $249.51.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 30 procedure codes: S9484 at 7.1× median, 90837 at 4.4× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
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.
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.
Unusually High Spending
Unusually High Spending means this provider's total Medicaid payments are significantly above the median for their specialty. This doesn't necessarily indicate fraud — high volume practices and those serving complex populations may legitimately bill more.
High Cost Per Claim
High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $205.51 per claim for H2010 (Comprehensive medication services, per 15 min) — 3.3× the national median of $62.69.
Bills $1,781.62 per claim for S9484 (Crisis intervention mental health services, per hour) — 7.1× the national median of $249.51.
Bills $375.56 per claim for 90837 (Psychotherapy, 60 minutes) — 4.4× the national median of $85.66.
Billing in the top 1% nationally for 9 procedure codes: 90837, 90834, 99233.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center Mental Health (Including Community Mental Health Center) Peers
Total spending distribution among 28 providers in this specialty
This provider's total spending of $728.1M is at the 90th percentile among 28 Clinic/Center Mental Health (Including Community Mental Health Center) providers.
Above 90th percentile for this specialty — higher spending than 25 of 28 peers
Total Paid
$728.1M
$728,111,212
Total Claims
3.0M
Beneficiaries
1.5M
2.0 claims/patient
Avg Cost/Claim
$240
#63 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
County of Fresno is a Clinic/Center Mental Health (Including Community Mental Health Center) provider based in Fresno, CA. From the 2018–2024 period, this provider received $728.1M in Medicaid payments across 3.0M claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $728.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 91,013 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 27% of total spending.
$197.6M
832K claims
$237.35
$96.24
Comprehensive community support services, per 15 min
$197.6M
832K claims · 27.1%
$94.3M
442K claims
$213.39
$91.63
Psychosocial rehabilitation services, per 15 min
$94.3M
442K claims · 12.9%
$90.7M
670K claims
$135.39
$69.56
Targeted case management, per 15 min
$90.7M
670K claims · 12.5%
$77.8M
379K claims
$205.51
$62.69
Comprehensive medication services, per 15 min
$77.8M
379K claims · 10.7%
$71.7M
40K claims
$1,781.62
$249.51
Crisis intervention mental health services, per hour
$71.7M
40K claims · 9.9%
$38.7M
45K claims
$850.98
$841.93
Psychiatric health facility service, per diem
$38.7M
45K claims · 5.3%
Psychotherapy, 60 minutes
$37.7M
100K claims · 5.2%
$27.6M
214K claims
$129.22
$56.90
Medication training and management, per 15 min
$27.6M
214K claims · 3.8%
$21.0M
64K claims
$328.39
$84.12
Therapeutic behavioral services, per 15 min
$21.0M
64K claims · 2.9%
$10.3M
73K claims
$142.25
$80.64
Mental health service plan development
$10.3M
73K claims · 1.4%
$10.0M
38K claims
$265.21
$72.96
Prolonged office/outpatient E/M, each additional 15 min
$10.0M
38K claims · 1.4%
$9.9M
19K claims
$512.69
$215.80
Crisis intervention service, per 15 minutes
$9.9M
19K claims · 1.4%
$8.2M
18K claims
$455.71
$467.51
Behavioral health; short-term residential, per diem
$8.2M
18K claims · 1.1%
Psychotherapy, 45 minutes
$6.1M
21K claims · 0.8%
$5.2M
4K claims
$1,430.63
$35.30
Subsequent hospital care, per day, high complexity
$5.2M
4K claims · 0.7%
$4.7M
6K claims
$756.25
$74.09
Office/outpatient visit, high complexity
$4.7M
6K claims · 0.6%
$4.0M
7K claims
$541.16
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$4.0M
7K claims · 0.5%
$2.9M
7K claims
$438.98
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$2.9M
7K claims · 0.4%
$1.9M
6K claims
$320.87
$77.33
Family psychotherapy with patient, 50 min
$1.9M
6K claims · 0.3%
$1.2M
6K claims
$203.69
$25.06
Office/outpatient visit, low complexity
$1.2M
6K claims · 0.2%
Psychotherapy, 30 minutes
$1.2M
6K claims · 0.2%
Psychiatric diagnostic evaluation
$871K
9K claims · 0.1%
$788K
8K claims
$102.35
$31.37
Oral medication administration, direct observation
$788K
8K claims · 0.1%
$615K
4K claims
$141.07
$49.05
Nursing assessment/evaluation, per visit
$615K
4K claims · 0.1%
$563K
2K claims
$256.62
$108.91
Psychiatric diagnostic evaluation with medical services
$563K
2K claims · 0.1%
$458K
352 claims · 0.1%
$376K
2K claims
$159.93
$55.04
Self-help/peer services, per 15 minutes
$376K
2K claims · 0.1%
$271K
2K claims
$116.60
$96.18
Mental health assessment by non-physician
$271K
2K claims · 0.0%
$256K
806 claims
$317.85
$114.71
Comprehensive multidisciplinary evaluation
$256K
806 claims · 0.0%
$253K
174 claims
$1,451.21
$111.09
Office/outpatient visit, new patient, high complexity
$253K
174 claims · 0.0%
Other Top Providers in California
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$6.78B
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$1.73B
County of Riverside
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$1.40B
City & County of San Francisco
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$1.34B
Los Angeles County Department of Public Health
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$1.13B
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