Is GRAFTON SCHOOL INC flagged for Medicaid fraud?

GRAFTON SCHOOL INC (NPI: 1932279072) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does GRAFTON SCHOOL INC bill Medicaid?

GRAFTON SCHOOL INC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Psychiatric Residential Treatment Facility provider. Located in WINCHESTER, VA.

What is NPI 1932279072?

NPI 1932279072 is the National Provider Identifier for GRAFTON SCHOOL INC. They are a Psychiatric Residential Treatment Facility provider based in WINCHESTER, VA. This NPI is registered with the CMS NPI Registry.

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GRAFTON SCHOOL INC

Psychiatric Residential Treatment Facility·WINCHESTER, VA·NPI: 1932279072Share

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

Total Paid

$33.0M

$33,028,746

Total Claims

174K

Beneficiaries

23K

7.5 claims/patient

Avg Cost/Claim

$190

Monthly Spending Trend

Yearly Spending

2018

$4.0M

+22%

2019

$4.9M

+56%

2020

$7.7M

-7%

2021

$7.1M

-34%

2022

$4.7M

-7%

2023

$4.4M

-94%

2024

$251K

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 16 distinct procedure codes. The top code (H0019 (Behavioral health; residential, per diem)) accounts for 91% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0019Behavioral health; residential, per diemSee all providers →

$30.2M

89K claims

$339.36

$357.16

1.0×

Normal range

H0019Normal range

Behavioral health; residential, per diem

$30.2M

89K claims · 91.3%

Your Cost: $339.36/claim|Median: $357.16

1.0× median

90832Psychotherapy, 30 minutesSee all providers →

$1.6M

45K claims

$34.23

$41.28

0.8×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$1.6M

45K claims · 4.7%

Your Cost: $34.23/claim|Median: $41.28

0.8× median

90847Family psychotherapy with patient, 50 minSee all providers →

$258K

4,791 claims

$53.80

$77.33

0.7×

Normal range

90847Normal range

Family psychotherapy with patient, 50 min

$258K

4,791 claims · 0.8%

Your Cost: $53.80/claim|Median: $77.33

0.7× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$237K

6,260 claims

$37.89

$37.81

1.0×

Normal range

99213Normal range

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

$237K

6,260 claims · 0.7%

Your Cost: $37.89/claim|Median: $37.81

1.0× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$195K

3,576 claims

$54.59

$53.41

1.0×

Normal range

99214Normal range

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

$195K

3,576 claims · 0.6%

Your Cost: $54.59/claim|Median: $53.41

1.0× median

97152 See all providers →

$167K

5,175 claims

$32.32

$155.16

0.2×

Normal range

97152Normal range

$167K

5,175 claims · 0.5%

Your Cost: $32.32/claim|Median: $155.16

0.2× median

90834Psychotherapy, 45 minutesSee all providers →

$139K

3,099 claims

$44.94

$63.65

0.7×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$139K

3,099 claims · 0.4%

Your Cost: $44.94/claim|Median: $63.65

0.7× median

90853Group psychotherapySee all providers →

$97K

7,244 claims

$13.45

$25.02

0.5×

Normal range

90853Normal range

Group psychotherapy

$97K

7,244 claims · 0.3%

Your Cost: $13.45/claim|Median: $25.02

0.5× median

99212Office/outpatient visit, low complexitySee all providers →

$91K

3,394 claims

$26.77

$25.06

1.1×

Normal range

99212Normal range

Office/outpatient visit, low complexity

$91K

3,394 claims · 0.3%

Your Cost: $26.77/claim|Median: $25.06

1.1× median

90846Family psychotherapy without patient, 50 minSee all providers →

$63K

1,238 claims

$51.06

$76.61

0.7×

Normal range

90846Normal range

Family psychotherapy without patient, 50 min

$63K

1,238 claims · 0.2%

Your Cost: $51.06/claim|Median: $76.61

0.7× median

99211Office/outpatient visit, minimal complexitySee all providers →

$39K

3,165 claims

$12.18

$12.93

0.9×

Normal range

99211Normal range

Office/outpatient visit, minimal complexity

$39K

3,165 claims · 0.1%

Your Cost: $12.18/claim|Median: $12.93

0.9× median

90837Psychotherapy, 60 minutesSee all providers →

$16K

397 claims

$41.55

$85.66

0.5×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$16K

397 claims · 0.0%

Your Cost: $41.55/claim|Median: $85.66

0.5× median

0360T See all providers →

$11K

1,296 claims

$8.34

$46.02

0.2×

Normal range

0360TNormal range

$11K

1,296 claims · 0.0%

Your Cost: $8.34/claim|Median: $46.02

0.2× median

T2022Case management, per monthSee all providers →

$149

181 claims

$0.82

$202.77

0.0×

Normal range

T2022Normal range

Case management, per month

$149

181 claims · 0.0%

Your Cost: $0.82/claim|Median: $202.77

0.0× median

11001 See all providers →

20 claims

$0.00

$0.23

—

Normal range

11001Normal range

20 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.23

0361T See all providers →

222 claims

$0.00

$89.95

—

Normal range

0361TNormal range

222 claims · 0.0%

Your Cost: $0.00/claim|Median: $89.95

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