Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Community Mental Health for Central Michigan

Psychiatry & Neurology Psychiatry·MT Pleasant, MI·NPI: 1881622892SharePrint Report
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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:

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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

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Bills $254.66 per claim for T1017 (Targeted case management, per 15 min) — 3.7× the national median of $69.56.

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Bills $370.85 per claim for H0036 (Community psychiatric supportive treatment, per 15 min) — 4.9× the national median of $76.05.

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Bills $334.11 per claim for 99214 (Office/outpatient visit, est. patient, mod-high complexity) — 6.3× the national median of $53.41.

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Billing in the top 1% nationally for 10 procedure codes: 99214, T1023, S5161.

This is a statistical summary, not an accusation. See our methodology.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$255.7M

$255,698,082

Total Claims

935K

Beneficiaries

584K

1.6 claims/patient

Avg Cost/Claim

$273

#323 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Community Mental Health for Central Michigan is a Psychiatry & Neurology Psychiatry provider based in MT Pleasant, MI. From the 2018–2024 period, this provider received $255.7M in Medicaid payments across 935K claims.

Why This Matters

This provider received $255.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 31,962 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 38% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$29.5M
+5%
2019
$31.0M
-7%
2020
$28.7M
+17%
2021
$33.6M
+33%
2022
$44.8M
+6%
2023
$47.5M
-14%
2024
$40.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1017 (Targeted case management, per 15 min)) accounts for 20% of total spending.

T1017Top 25%

Targeted case management, per 15 min

$51.7M

203K claims · 20.2%

Your Cost: $254.66/claim|Median: $69.56
3.7× median
H0036Top 5%

Community psychiatric supportive treatment, per 15 min

$19.7M

53K claims · 7.7%

Your Cost: $370.85/claim|Median: $76.05
4.9× median
H0039Top 25%

Assertive community treatment, per diem

$18.4M

72K claims · 7.2%

Your Cost: $256.16/claim|Median: $132.62
1.9× median
90837Top 5%

Psychotherapy, 60 minutes

$14.5M

70K claims · 5.7%

Your Cost: $206.77/claim|Median: $85.66
2.4× median
99214Top 1%

Office/outpatient visit, est. patient, mod-high complexity

$14.1M

42K claims · 5.5%

Your Cost: $334.11/claim|Median: $53.41
6.3× median
T1023Top 1%

Screening to determine appropriateness of consideration for program

$12.8M

13K claims · 5.0%

Your Cost: $1,010.89/claim|Median: $106.70
9.5× median
S5161Top 1%

Emergency response system, per month

$11.0M

6K claims · 4.3%

Your Cost: $1,766.48/claim|Median: $29.97
58.9× median
90847Top 10%

Family psychotherapy with patient, 50 min

$9.6M

49K claims · 3.8%

Your Cost: $196.55/claim|Median: $77.33
2.5× median
T1016Top 25%

Case management, each 15 min

$9.4M

51K claims · 3.7%

Your Cost: $185.32/claim|Median: $49.62
3.7× median
90791Top 1%

Psychiatric diagnostic evaluation

$8.5M

13K claims · 3.3%

Your Cost: $631.98/claim|Median: $99.21
6.4× median
99213Top 1%

Office/outpatient visit, est. patient, low-mod complexity

$7.4M

32K claims · 2.9%

Your Cost: $233.82/claim|Median: $37.81
6.2× median
H2030Top 25%

Mental health clubhouse services, per 15 minutes

$6.7M

55K claims · 2.6%

Your Cost: $120.31/claim|Median: $73.58
1.6× median
H2023Top 5%

Supported employment, per 15 min

$6.1M

13K claims · 2.4%

Your Cost: $474.53/claim|Median: $103.94
4.6× median
90834Top 5%

Psychotherapy, 45 minutes

$5.9M

35K claims · 2.3%

Your Cost: $166.48/claim|Median: $63.65
2.6× median
H0031Top 10%

Mental health assessment by non-physician

$4.9M

16K claims · 1.9%

Your Cost: $305.16/claim|Median: $96.18
3.2× median
H2033Top 25%

Multisystemic therapy for juveniles, per 15 minutes

$4.8M

9K claims · 1.9%

Your Cost: $531.00/claim|Median: $227.82
2.3× median
97155Top 1%

Adaptive behavior treatment with protocol modification, per 15 minutes

$4.6M

5K claims · 1.8%

Your Cost: $978.75/claim|Median: $146.45
6.7× median
90792Top 1%

Psychiatric diagnostic evaluation with medical services

$4.4M

4K claims · 1.7%

Your Cost: $1,031.80/claim|Median: $108.91
9.5× median
H2011Normal range

Crisis intervention service, per 15 minutes

$4.3M

10K claims · 1.7%

Your Cost: $412.01/claim|Median: $215.80
1.9× median
H2019Top 25%

Therapeutic behavioral services, per 15 min

$4.2M

22K claims · 1.6%

Your Cost: $192.16/claim|Median: $84.12
2.3× median
S9445Top 1%

$4.1M

9K claims · 1.6%

Your Cost: $479.76/claim|Median: $12.72
37.7× median
H0032Top 25%

Mental health service plan development

$3.6M

22K claims · 1.4%

Your Cost: $164.16/claim|Median: $80.64
2.0× median
96372Top 1%

Therapeutic injection, subcutaneous/intramuscular

$3.3M

17K claims · 1.3%

Your Cost: $187.80/claim|Median: $9.56
19.6× median
H0038Top 10%

Self-help/peer services, per 15 minutes

$2.9M

11K claims · 1.1%

Your Cost: $268.89/claim|Median: $55.04
4.9× median
90832Top 10%

Psychotherapy, 30 minutes

$2.8M

27K claims · 1.1%

Your Cost: $105.74/claim|Median: $41.28
2.6× median
H2021Top 10%

Community-based wrap-around services, per 15 min

$2.3M

3K claims · 0.9%

Your Cost: $800.45/claim|Median: $169.11
4.7× median
S5111Top 10%

Home care training, family member, per session

$2.3M

9K claims · 0.9%

Your Cost: $250.83/claim|Median: $87.13
2.9× median
T1001Top 1%

Nursing assessment/evaluation, per visit

$2.0M

4K claims · 0.8%

Your Cost: $522.08/claim|Median: $49.05
10.6× median
90846Top 5%

Family psychotherapy without patient, 50 min

$1.1M

6K claims · 0.4%

Your Cost: $196.66/claim|Median: $76.61
2.6× median
90853Top 5%

Group psychotherapy

$990K

8K claims · 0.4%

Your Cost: $123.41/claim|Median: $25.02
4.9× median

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