County of Sonoma
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 22 procedure codes: S9484 at 14.1× median, H0032 at 3.0× median.
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:
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 $364.96 per claim for H2010 (Comprehensive medication services, per 15 min) — 5.8× the national median of $62.69.
Bills $290.09 per claim for H2015 (Comprehensive community support services, per 15 min) — 3.0× the national median of $96.24.
Bills $3,519.56 per claim for S9484 (Crisis intervention mental health services, per hour) — 14.1× the national median of $249.51.
Billing in the top 1% nationally for 12 procedure codes: 99215, 99214, 90837.
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 44 providers in this specialty
This provider's total spending of $195.1M is at the 90th percentile among 44 Clinic/Center, Mental Health (Including Community Mental Health Center) providers.
Above 90th percentile for this specialty — higher spending than 39 of 44 peers
Total Paid
$195.1M
$195,090,095
Total Claims
628K
Beneficiaries
244K
2.6 claims/patient
Avg Cost/Claim
$311
#473 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
County of Sonoma is a Clinic/Center, Mental Health (Including Community Mental Health Center) provider based in Santa Rosa, CA. From the 2018–2024 period, this provider received $195.1M in Medicaid payments across 628K 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 $195.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,386 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 (H2010 (Comprehensive medication services, per 15 min)) accounts for 22% of total spending.
$42.8M
117K claims
$364.96
$62.69
Comprehensive medication services, per 15 min
$42.8M
117K claims · 21.9%
$34.8M
120K claims
$290.09
$96.24
Comprehensive community support services, per 15 min
$34.8M
120K claims · 17.9%
$31.8M
9K claims
$3,519.56
$249.51
Crisis intervention mental health services, per hour
$31.8M
9K claims · 16.3%
$21.3M
129K claims
$164.93
$69.56
Targeted case management, per 15 min
$21.3M
129K claims · 10.9%
$18.6M
121K claims
$153.09
$91.63
Psychosocial rehabilitation services, per 15 min
$18.6M
121K claims · 9.5%
$14.7M
36K claims
$405.52
$467.51
Behavioral health; short-term residential, per diem
$14.7M
36K claims · 7.5%
$8.5M
35K claims
$244.22
$80.64
Mental health service plan development
$8.5M
35K claims · 4.3%
$6.4M
6K claims
$1,137.88
$841.93
Psychiatric health facility service, per diem
$6.4M
6K claims · 3.3%
$3.2M
14K claims
$225.08
$84.12
Therapeutic behavioral services, per 15 min
$3.2M
14K claims · 1.6%
$3.0M
11K claims
$273.95
$357.16
Behavioral health; residential, per diem
$3.0M
11K claims · 1.6%
$1.9M
3K claims
$692.00
$74.09
Office/outpatient visit, high complexity
$1.9M
3K claims · 1.0%
$1.3M
3K claims
$449.69
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$1.3M
3K claims · 0.7%
$1.1M
2K claims
$458.49
$72.96
Prolonged office/outpatient E/M, each additional 15 min
$1.1M
2K claims · 0.6%
Psychotherapy, 60 minutes
$1.1M
3K claims · 0.6%
$1.1M
6K claims
$188.61
$56.90
Medication training and management, per 15 min
$1.1M
6K claims · 0.6%
$1.1M
779 claims
$1,382.21
$35.30
Subsequent hospital care, per day, high complexity
$1.1M
779 claims · 0.6%
$499K
816 claims
$611.75
$215.80
Crisis intervention service, per 15 minutes
$499K
816 claims · 0.3%
$359K
1K claims
$348.30
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$359K
1K claims · 0.2%
Psychotherapy, 45 minutes
$323K
1K claims · 0.2%
$182K
121 claims
$1,506.94
$111.09
Office/outpatient visit, new patient, high complexity
$182K
121 claims · 0.1%
$157K
1K claims
$150.57
$9.56
Therapeutic injection, subcutaneous/intramuscular
$157K
1K claims · 0.1%
Psychiatric diagnostic evaluation
$119K
1K claims · 0.1%
$118K
117 claims
$1,008.25
$23.99
Subsequent hospital care, per day, moderate complexity
$118K
117 claims · 0.1%
$110K
76 claims
$1,452.09
$43.85
Hospital discharge day management, more than 30 minutes
$110K
76 claims · 0.1%
$102K
4K claims
$26.02
$30.88
Unlisted evaluation and management service
$102K
4K claims · 0.1%
$85K
234 claims
$363.27
$108.91
Psychiatric diagnostic evaluation with medical services
$85K
234 claims · 0.0%
$51K
181 claims
$282.72
$96.18
Mental health assessment by non-physician
$51K
181 claims · 0.0%
$51K
25 claims
$2,038.16
$67.32
Initial hospital care, per day, high complexity
$51K
25 claims · 0.0%
Telephone E/M by physician, 21-30 min
$48K
96 claims · 0.0%
$40K
44 claims
$898.76
$57.85
Office/outpatient visit, new patient, low-mod complexity
$40K
44 claims · 0.0%
Other Top Providers in California
View all →Los Angeles County Department of Mental Health
Clinic/Center, Mental Health (Including Community
$6.78B
County of Santa Clara
Community/Behavioral Health
$1.73B
County of Riverside
Community/Behavioral Health
$1.40B
City & County of San Francisco
Community/Behavioral Health
$1.34B
Los Angeles County Department of Public Health
Public Health or Welfare
$1.13B
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