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Gandara Mental Health Center INC

Counselor Mental Health·Springfield, MA·NPI: 1134107113Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$133.3M

$133,340,173

Total Claims

1.4M

Beneficiaries

220K

6.4 claims/patient

Avg Cost/Claim

$95

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

🔍 Analysis

Provider Overview

Gandara Mental Health Center INC is a Counselor Mental Health provider based in Springfield, MA. From the 2018–2024 period, this provider received $133.3M in Medicaid payments across 1.4M claims.

Why This Matters

This provider received $133.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,667 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 44% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$14.1M
+34%
2019
$18.9M
+1%
2020
$19.1M
-2%
2021
$18.6M
+7%
2022
$20.0M
+11%
2023
$22.2M
-8%
2024
$20.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 27 distinct procedure codes. The top code (H2019 (Therapeutic behavioral services, per 15 min)) accounts for 29% of total spending.

H2019Top 25%

Therapeutic behavioral services, per 15 min

$38.6M

259K claims · 29.0%

Your Cost: $149.35/claim|Median: $84.12
1.8× median
H0019Normal range

Behavioral health; residential, per diem

$30.7M

184K claims · 23.0%

Your Cost: $166.65/claim|Median: $357.16
0.5× median
H0023Normal range

Behavioral health outreach service, per 15 minutes

$16.3M

300K claims · 12.2%

Your Cost: $54.14/claim|Median: $53.97
1.0× median
H2014Top 25%

Skills training & development, per 15 min

$14.2M

96K claims · 10.7%

Your Cost: $149.14/claim|Median: $83.88
1.8× median
T1027Top 10%

Family training and counseling, per 15 minutes

$11.2M

98K claims · 8.4%

Your Cost: $114.27/claim|Median: $53.00
2.2× median
90834Top 25%

Psychotherapy, 45 minutes

$7.7M

84K claims · 5.7%

Your Cost: $90.96/claim|Median: $63.65
1.4× median
H2016Normal range

Comprehensive community support services, per 15 min

$4.5M

259K claims · 3.4%

Your Cost: $17.50/claim|Median: $321.53
0.1× median
90837Top 25%

Psychotherapy, 60 minutes

$3.4M

28K claims · 2.5%

Your Cost: $120.53/claim|Median: $85.66
1.4× median
H2015Normal range

Comprehensive community support services, per 15 min

$1.3M

16K claims · 0.9%

Your Cost: $77.32/claim|Median: $96.24
0.8× median
90791Top 25%

Psychiatric diagnostic evaluation

$1.0M

7K claims · 0.8%

Your Cost: $140.44/claim|Median: $99.21
1.4× median
99213Top 25%

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

$1.0M

17K claims · 0.8%

Your Cost: $60.47/claim|Median: $37.81
1.6× median
99214Top 25%

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

$727K

8K claims · 0.5%

Your Cost: $92.06/claim|Median: $53.41
1.7× median
90882Top 25%

Environmental intervention

$658K

9K claims · 0.5%

Your Cost: $75.48/claim|Median: $45.05
1.7× median
90853Normal range

Group psychotherapy

$653K

20K claims · 0.5%

Your Cost: $32.80/claim|Median: $25.02
1.3× median
90832Normal range

Psychotherapy, 30 minutes

$474K

10K claims · 0.4%

Your Cost: $49.51/claim|Median: $41.28
1.2× median
H0015Normal range

Alcohol and/or drug abuse, intensive outpatient, per hour

$233K

3K claims · 0.2%

Your Cost: $83.13/claim|Median: $129.75
0.6× median
99215Normal range

Office/outpatient visit, high complexity

$220K

2K claims · 0.2%

Your Cost: $103.15/claim|Median: $74.09
1.4× median
99205Top 25%

Office/outpatient visit, new patient, high complexity

$131K

746 claims · 0.1%

Your Cost: $175.65/claim|Median: $111.09
1.6× median
99212Normal range

Office/outpatient visit, low complexity

$124K

4K claims · 0.1%

Your Cost: $33.08/claim|Median: $25.06
1.3× median
H0038Normal range

Self-help/peer services, per 15 minutes

$111K

1K claims · 0.1%

Your Cost: $90.26/claim|Median: $55.04
1.6× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$57K

404 claims · 0.0%

Your Cost: $140.63/claim|Median: $84.03
1.7× median
H0046Normal range

Mental health services, not otherwise specified

$31K

845 claims · 0.0%

Your Cost: $36.46/claim|Median: $85.02
0.4× median
90847Normal range

Family psychotherapy with patient, 50 min

$29K

298 claims · 0.0%

Your Cost: $98.57/claim|Median: $77.33
1.3× median
99203Top 25%

Office/outpatient visit, new patient, low-mod complexity

$15K

188 claims · 0.0%

Your Cost: $81.91/claim|Median: $57.85
1.4× median
99211Normal range

Office/outpatient visit, minimal complexity

$11K

746 claims · 0.0%

Your Cost: $15.30/claim|Median: $12.93
1.2× median
99202Normal range

Office/outpatient visit, new patient, low complexity

$2K

30 claims · 0.0%

Your Cost: $55.64/claim|Median: $40.11
1.4× median
99201Normal range

Office/outpatient visit, new patient, straightforward

$1K

43 claims · 0.0%

Your Cost: $32.08/claim|Median: $27.38
1.2× median

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