Is BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC flagged for Medicaid fraud?

BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC (NPI: 1952840860) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC bill Medicaid?

BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Behavior Analyst provider. Located in EDGEWOOD, KY.

What is NPI 1952840860?

NPI 1952840860 is the National Provider Identifier for BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC. They are a Behavior Analyst provider based in EDGEWOOD, KY. This NPI is registered with the CMS NPI Registry.

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BLUEGRASS BEHAVIORAL HEALTH GROUP, LLC

Behavior Analyst·EDGEWOOD, KY·NPI: 1952840860Share

Compared to Behavior Analyst Peers

Total spending distribution among 31 providers in this specialty

P25MedianP75P90

This provider's total spending of $23.7M is at the 75th percentile among 31 Behavior Analyst providers.

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

Total Paid

$23.7M

$23,691,900

Total Claims

145K

Beneficiaries

61K

2.4 claims/patient

Avg Cost/Claim

$163

Monthly Spending Trend

Yearly Spending

2018

$1.4M

+117%

2019

$3.0M

+18%

2020

$3.6M

+13%

2021

$4.0M

-9%

2022

$3.7M

+13%

2023

$4.1M

-7%

2024

$3.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 19 distinct procedure codes. The top code (H0004 (Behavioral health counseling & therapy, per 15 min)) accounts for 57% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

H0004Behavioral health counseling & therapy, per 15 minSee all providers →

$13.5M

39K claims

$345.89

$74.63

4.6×

Top 5%

H0004Top 5%

Behavioral health counseling & therapy, per 15 min

$13.5M

39K claims · 57.0%

Your Cost: $345.89/claim|Median: $74.63

4.6× median

T2023Community transition, waiver; per serviceSee all providers →

$4.9M

19K claims

$262.59

$300.13

0.9×

Normal range

T2023Normal range

Community transition, waiver; per service

$4.9M

19K claims · 20.8%

Your Cost: $262.59/claim|Median: $300.13

0.9× median

90837Psychotherapy, 60 minutesSee all providers →

$3.0M

47K claims

$63.75

$85.66

0.7×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$3.0M

47K claims · 12.7%

Your Cost: $63.75/claim|Median: $85.66

0.7× median

97153Adaptive behavior treatment by protocol, per 15 minSee all providers →

$604K

3,230 claims

$186.87

$167.38

1.1×

Normal range

97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$604K

3,230 claims · 2.5%

Your Cost: $186.87/claim|Median: $167.38

1.1× median

99354 See all providers →

$480K

8,802 claims

$54.55

$54.96

1.0×

Normal range

99354Normal range

$480K

8,802 claims · 2.0%

Your Cost: $54.55/claim|Median: $54.96

1.0× median

90832Psychotherapy, 30 minutesSee all providers →

$356K

11K claims

$33.33

$41.28

0.8×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$356K

11K claims · 1.5%

Your Cost: $33.33/claim|Median: $41.28

0.8× median

90834Psychotherapy, 45 minutesSee all providers →

$242K

5,650 claims

$42.84

$63.65

0.7×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$242K

5,650 claims · 1.0%

Your Cost: $42.84/claim|Median: $63.65

0.7× median

90887Interpretation/explanation of resultsSee all providers →

$135K

4,486 claims

$30.04

$47.55

0.6×

Normal range

90887Normal range

Interpretation/explanation of results

$135K

4,486 claims · 0.6%

Your Cost: $30.04/claim|Median: $47.55

0.6× median

99355 See all providers →

$87K

1,707 claims

$50.78

$55.81

0.9×

Normal range

99355Normal range

$87K

1,707 claims · 0.4%

Your Cost: $50.78/claim|Median: $55.81

0.9× median

97155Adaptive behavior treatment with protocol modification, per 15 minutesSee all providers →

$79K

862 claims

$91.69

$146.45

0.6×

Normal range

97155Normal range

Adaptive behavior treatment with protocol modification, per 15 minutes

$79K

862 claims · 0.3%

Your Cost: $91.69/claim|Median: $146.45

0.6× median

H0032Mental health service plan developmentSee all providers →

$73K

1,282 claims

$56.56

$80.64

0.7×

Normal range

H0032Normal range

Mental health service plan development

$73K

1,282 claims · 0.3%

Your Cost: $56.56/claim|Median: $80.64

0.7× median

90846Family psychotherapy without patient, 50 minSee all providers →

$71K

1,505 claims

$47.21

$76.61

0.6×

Normal range

90846Normal range

Family psychotherapy without patient, 50 min

$71K

1,505 claims · 0.3%

Your Cost: $47.21/claim|Median: $76.61

0.6× median

H2015Comprehensive community support services, per 15 minSee all providers →

$36K

486 claims

$73.51

$96.24

0.8×

Normal range

H2015Normal range

Comprehensive community support services, per 15 min

$36K

486 claims · 0.2%

Your Cost: $73.51/claim|Median: $96.24

0.8× median

97535Self-care/home management training, per 15 minutesSee all providers →

$25K

346 claims

$72.52

$18.18

4.0×

Top 10%

97535Top 10%

Self-care/home management training, per 15 minutes

$25K

346 claims · 0.1%

Your Cost: $72.52/claim|Median: $18.18

4.0× median

90791Psychiatric diagnostic evaluationSee all providers →

$20K

285 claims

$69.29

$99.21

0.7×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$20K

285 claims · 0.1%

Your Cost: $69.29/claim|Median: $99.21

0.7× median

90847Family psychotherapy with patient, 50 minSee all providers →

$19K

422 claims

$45.31

$77.33

0.6×

Normal range

90847Normal range

Family psychotherapy with patient, 50 min

$19K

422 claims · 0.1%

Your Cost: $45.31/claim|Median: $77.33

0.6× median

H0031Mental health assessment by non-physicianSee all providers →

$10K

189 claims

$50.48

$96.18

0.5×

Normal range

H0031Normal range

Mental health assessment by non-physician

$10K

189 claims · 0.0%

Your Cost: $50.48/claim|Median: $96.18

0.5× median

97154Group adaptive behavior treatment, per 15 minSee all providers →

$7K

259 claims

$28.28

$55.95

0.5×

Normal range

97154Normal range

Group adaptive behavior treatment, per 15 min

$7K

259 claims · 0.0%

Your Cost: $28.28/claim|Median: $55.95

0.5× median

97156 See all providers →

$726

21 claims

$34.57

$88.65

0.4×

Normal range

97156Normal range

$726

21 claims · 0.0%

Your Cost: $34.57/claim|Median: $88.65

0.4× median

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