Beth Israel Medical Center
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $1.2M (2018) to $21.4M (2019) — a 1742% swing with $20.2M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 125 procedure codes: G2067 at 3.1× median, 99214 at 2.1× median.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1742% from 2018 to 2019.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
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:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
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.
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $229.34 per claim for G2067 (Medication-assisted treatment, opioid use disorder, per month) — 3.1× the national median of $73.29.
Bills $921.39 per claim for 90791 (Psychiatric diagnostic evaluation) — 9.3× the national median of $99.21.
Bills $168.17 per claim for 99283 (Emergency dept visit, moderate complexity) — 4.0× the national median of $42.48.
Billing in the top 1% nationally for 2 procedure codes: G2067, 90791.
This is a statistical summary, not an accusation. See our methodology.
Compared to Psychiatric Unit Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $278.7M is at the 99th percentile among 8 Psychiatric Unit providers.
Above 99th percentile for this specialty — higher spending than 7 of 8 peers
Total Paid
$278.7M
$278,662,434
Total Claims
4.4M
Beneficiaries
2.7M
1.6 claims/patient
Avg Cost/Claim
$63
#279 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Beth Israel Medical Center is a Psychiatric Unit provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $278.7M in Medicaid payments across 4.4M claims.
Why This Matters
This provider received $278.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 34,832 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (G2067 (Medication-assisted treatment, opioid use disorder, per month)) accounts for 16% of total spending.
$43.4M
189K claims
$229.34
$73.29
Medication-assisted treatment, opioid use disorder, per month
$43.4M
189K claims · 15.6%
$33.3M
989K claims
$33.70
$18.95
Alcohol/drug services; methadone administration
$33.3M
989K claims · 12.0%
$21.4M
186K claims
$114.76
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$21.4M
186K claims · 7.7%
$15.5M
137K claims
$113.03
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$15.5M
137K claims · 5.6%
$12.7M
119K claims
$107.30
$40.58
Alcohol/substance abuse structured assessment, 15-30 minutes
$12.7M
119K claims · 4.6%
Psychiatric diagnostic evaluation
$9.6M
10K claims · 3.4%
Injection, pembrolizumab, 1 mg
$9.5M
914 claims · 3.4%
$8.1M
48K claims
$168.17
$42.48
Emergency dept visit, moderate complexity
$8.1M
48K claims · 2.9%
$5.2M
31K claims
$164.28
$69.51
Emergency dept visit, high complexity
$5.2M
31K claims · 1.8%
$5.1M
3K claims
$1,842.97
$266.41
Assertive community treatment, face-to-face, per 15 minutes
$5.1M
3K claims · 1.8%
$4.2M
30K claims
$140.14
$74.09
Office/outpatient visit, high complexity
$4.2M
30K claims · 1.5%
Psychotherapy, 45 minutes
$4.1M
24K claims · 1.5%
$4.1M
27K claims
$151.24
$85.65
Emergency dept visit, high/urgent complexity
$4.1M
27K claims · 1.5%
$3.4M
30K claims
$112.14
$25.06
Office/outpatient visit, low complexity
$3.4M
30K claims · 1.2%
$3.3M
22K claims
$155.47
$84.03
Office/outpatient visit, new patient, mod-high complexity
$3.3M
22K claims · 1.2%
Hospital observation service, per hour
$3.0M
3K claims · 1.1%
$2.8M
349K claims
$8.09
$1.57
Collection of venous blood by venipuncture
$2.8M
349K claims · 1.0%
Therapeutic exercises, each 15 min
$2.6M
44K claims · 0.9%
$2.5M
18K claims · 0.9%
$2.4M
40K claims
$60.94
$60.05
COVID-19 test, nucleic acid detection, CDC lab only
$2.4M
40K claims · 0.9%
$2.2M
12K claims
$178.62
$38.92
IV infusion, hydration, each additional hour
$2.2M
12K claims · 0.8%
$2.1M
15K claims
$143.32
$57.85
Office/outpatient visit, new patient, low-mod complexity
$2.1M
15K claims · 0.8%
$1.7M
987 claims · 0.6%
$1.7M
491 claims · 0.6%
$1.5M
9K claims
$164.35
$75.28
Chemotherapy administration, IV infusion, up to 1 hour
$1.5M
9K claims · 0.6%
$1.5M
30K claims
$51.62
$74.63
Behavioral health counseling & therapy, per 15 min
$1.5M
30K claims · 0.5%
$1.5M
7K claims
$209.06
$54.68
Echocardiography, transthoracic, complete, with Doppler
$1.5M
7K claims · 0.5%
$1.5M
1K claims
$1,421.70
$493.25
Injection, denosumab, one milligram
$1.5M
1K claims · 0.5%
CT abdomen and pelvis with contrast
$1.3M
7K claims · 0.5%
$1.2M
27K claims · 0.4%
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