San Joaquin Behavioral Health Services
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 8 procedure codes: H2019 at 3.2× median, 90837 at 1.6× median.
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:
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.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $275.31 per claim for H2010 (Comprehensive medication services, per 15 min) — 4.4× the national median of $62.69.
Bills $270.87 per claim for H2019 (Therapeutic behavioral services, per 15 min) — 3.2× the national median of $84.12.
Bills $30.07 per claim for S5000 (Prescription drug, generic) — 4.0× the national median of $7.47.
Billing above the 90th percentile for 6 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Counselor, Addiction (Substance Use Disorder) Peers
Total spending distribution among 20 providers in this specialty
This provider's total spending of $211.5M is at the 75th percentile among 20 Counselor, Addiction (Substance Use Disorder) providers.
Total Paid
$211.5M
$211,489,379
Total Claims
3.6M
Beneficiaries
371K
9.8 claims/patient
Avg Cost/Claim
$58
#417 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
San Joaquin Behavioral Health Services is a Counselor, Addiction (Substance Use Disorder) provider based in Stockton, CA. From the 2018–2024 period, this provider received $211.5M in Medicaid payments across 3.6M claims.
Why This Matters
This provider received $211.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,436 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 (H2015 (Comprehensive community support services, per 15 min)) accounts for 20% of total spending.
$41.6M
231K claims
$179.99
$96.24
Comprehensive community support services, per 15 min
$41.6M
231K claims · 19.7%
$41.5M
29K claims
$1,410.38
$841.93
Psychiatric health facility service, per diem
$41.5M
29K claims · 19.6%
$39.0M
2.7M claims
$14.55
$18.95
Alcohol/drug services; methadone administration
$39.0M
2.7M claims · 18.4%
$26.9M
292K claims
$92.11
$74.63
Behavioral health counseling & therapy, per 15 min
$26.9M
292K claims · 12.7%
$19.6M
52K claims
$377.59
$467.51
Behavioral health; short-term residential, per diem
$19.6M
52K claims · 9.3%
$12.1M
135K claims
$89.27
$69.56
Targeted case management, per 15 min
$12.1M
135K claims · 5.7%
$9.6M
40K claims
$242.85
$357.16
Behavioral health; residential, per diem
$9.6M
40K claims · 4.5%
$5.1M
19K claims
$275.31
$62.69
Comprehensive medication services, per 15 min
$5.1M
19K claims · 2.4%
$4.7M
17K claims
$270.87
$84.12
Therapeutic behavioral services, per 15 min
$4.7M
17K claims · 2.2%
$4.0M
33K claims
$122.62
$91.63
Psychosocial rehabilitation services, per 15 min
$4.0M
33K claims · 1.9%
Psychotherapy, 60 minutes
$1.4M
10K claims · 0.7%
Prescription drug, generic
$1.2M
41K claims · 0.6%
$927K
4K claims
$220.43
$74.09
Office/outpatient visit, high complexity
$927K
4K claims · 0.4%
$780K
6K claims
$139.43
$72.96
Prolonged office/outpatient E/M, each additional 15 min
$780K
6K claims · 0.4%
$655K
6K claims
$101.25
$80.64
Mental health service plan development
$655K
6K claims · 0.3%
$565K
5K claims
$125.15
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$565K
5K claims · 0.3%
Psychotherapy, 45 minutes
$432K
3K claims · 0.2%
$336K
5K claims
$62.05
$56.90
Medication training and management, per 15 min
$336K
5K claims · 0.2%
$312K
5K claims
$66.04
$215.80
Crisis intervention service, per 15 minutes
$312K
5K claims · 0.1%
$121K
2K claims
$74.92
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$121K
2K claims · 0.1%
$88K
2K claims
$51.54
$96.18
Mental health assessment by non-physician
$88K
2K claims · 0.0%
$85K
3K claims
$27.57
$47.35
Alcohol and/or drug services, group counseling
$85K
3K claims · 0.0%
$74K
2K claims
$41.36
$49.05
Nursing assessment/evaluation, per visit
$74K
2K claims · 0.0%
Day habilitation, waiver; per 15 min
$59K
126 claims · 0.0%
$55K
3K claims
$17.68
$31.37
Oral medication administration, direct observation
$55K
3K claims · 0.0%
Psychotherapy, 30 minutes
$49K
869 claims · 0.0%
$45K
304 claims
$148.43
$111.09
Office/outpatient visit, new patient, high complexity
$45K
304 claims · 0.0%
Psychiatric diagnostic evaluation
$45K
3K claims · 0.0%
$40K
2K claims
$26.28
$55.04
Self-help/peer services, per 15 minutes
$40K
2K claims · 0.0%
$37K
572 claims
$64.65
$169.11
Community-based wrap-around services, per 15 min
$37K
572 claims · 0.0%
Other Top Providers in California
View all →Los Angeles County Department of Mental Health
Clinic/Center, Mental Health (Including Community
$6.78B
County of Santa Clara
Community/Behavioral Health
$1.73B
County of Riverside
Community/Behavioral Health
$1.40B
City & County of San Francisco
Community/Behavioral Health
$1.34B
Los Angeles County Department of Public Health
Public Health or Welfare
$1.13B
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