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Department of Mental Health

Community/Behavioral Health·Worcester, MA·NPI: 1063630838Share

Compared to Community/Behavioral Health Peers

Total spending distribution among 218 providers in this specialty

P25MedianP75P90

This provider's total spending of $168.8M is at the 75th percentile among 218 Community/Behavioral Health providers.

Active Billing Period:2018-012024-10(70 months)
Sharp billing drop in final month

Total Paid

$168.8M

$168,780,836

Total Claims

623K

Beneficiaries

94K

6.7 claims/patient

Avg Cost/Claim

$271

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

🔍 Analysis

Provider Overview

Department of Mental Health is a Community/Behavioral Health provider based in Worcester, MA. From the 2018–2024 period, this provider received $168.8M in Medicaid payments across 623K 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 $168.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 21,097 Medicaid beneficiaries for a full year at average per-enrollee costs.

27% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$27.8M
+1%
2019
$28.1M
+20%
2020
$33.8M
-4%
2021
$32.5M
-53%
2022
$15.1M
-26%
2023
$11.3M
+80%
2024
$20.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 3 distinct procedure codes. The top code (H2018 (Psychosocial rehabilitation services, per diem)) accounts for 93% of total spending.

H2018Normal range

Psychosocial rehabilitation services, per diem

$156.3M

602K claims · 92.6%

Your Cost: $259.62/claim|Median: $392.63
0.7× median
H0019Normal range

Behavioral health; residential, per diem

$10.9M

21K claims · 6.5%

Your Cost: $521.46/claim|Median: $357.16
1.5× median
H0018Top 25%

Behavioral health; short-term residential, per diem

$1.6M

559 claims · 0.9%

Your Cost: $2,853.48/claim|Median: $467.51
6.1× median