Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Generations Health Association Inc.

Clinic/Center Mental Health (Including Community Mental Health Center)·Morrison, TN·NPI: 1245212380SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Cost Outlier

Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

Bills $639.08 per claim for H0043 (Supported housing, per diem) — 3.9× the national median of $164.87.

This is a statistical summary, not an accusation. See our methodology.

Compared to Clinic/Center Mental Health (Including Community Mental Health Center) Peers

Total spending distribution among 28 providers in this specialty

P25MedianP75P90

This provider's total spending of $136.7M is at the 25th percentile among 28 Clinic/Center Mental Health (Including Community Mental Health Center) providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$136.7M

$136,663,126

Total Claims

728K

Beneficiaries

316K

2.3 claims/patient

Avg Cost/Claim

$188

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

🔍 Analysis

Provider Overview

Generations Health Association Inc. is a Clinic/Center Mental Health (Including Community Mental Health Center) provider based in Morrison, TN. From the 2018–2024 period, this provider received $136.7M in Medicaid payments across 728K claims.

Why This Matters

This provider received $136.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 17,082 Medicaid beneficiaries for a full year at average per-enrollee costs.

52% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$14.6M
+15%
2019
$16.8M
+8%
2020
$18.2M
+5%
2021
$19.0M
+12%
2022
$21.3M
+16%
2023
$24.6M
-10%
2024
$22.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 27 distinct procedure codes. The top code (H0043 (Supported housing, per diem)) accounts for 92% of total spending.

H0043Top 25%

Supported housing, per diem

$125.2M

196K claims · 91.6%

Your Cost: $639.08/claim|Median: $164.87
3.9× median
S0280Normal range

Medical home program, comprehensive care management

$7.7M

88K claims · 5.6%

Your Cost: $87.73/claim|Median: $48.38
1.8× median
99213Normal range

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

$1.1M

68K claims · 0.8%

Your Cost: $16.63/claim|Median: $37.81
0.4× median
90834Normal range

Psychotherapy, 45 minutes

$821K

21K claims · 0.6%

Your Cost: $38.83/claim|Median: $63.65
0.6× median
90832Normal range

Psychotherapy, 30 minutes

$725K

34K claims · 0.5%

Your Cost: $21.29/claim|Median: $41.28
0.5× median
A0110Normal range

Non-emergency taxi transport

$299K

41K claims · 0.2%

Your Cost: $7.36/claim|Median: $9.27
0.8× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$218K

5K claims · 0.2%

Your Cost: $40.21/claim|Median: $108.91
0.4× median
90791Normal range

Psychiatric diagnostic evaluation

$212K

4K claims · 0.2%

Your Cost: $53.76/claim|Median: $99.21
0.5× median
99214Normal range

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

$211K

7K claims · 0.2%

Your Cost: $28.24/claim|Median: $53.41
0.5× median
A0425Normal range

Ground mileage, per statute mile

$88K

21K claims · 0.1%

Your Cost: $4.10/claim|Median: $23.36
0.2× median
90837Normal range

Psychotherapy, 60 minutes

$74K

1K claims · 0.1%

Your Cost: $58.10/claim|Median: $85.66
0.7× median
A0100Normal range

Non-emergency transportation; per trip

$14K

15K claims · 0.0%

Your Cost: $0.95/claim|Median: $24.72
0.0× median
90833Normal range

Psychotherapy, 30 min, add-on to E/M service

$2K

132 claims · 0.0%

Your Cost: $14.03/claim|Median: $38.83
0.4× median
G9004Normal range

$177

27K claims · 0.0%

Your Cost: $0.01/claim|Median: $55.49
0.0× median
G9005Normal range

Coordinated care fee, risk-adjusted, ESRD

$0

54K claims · 0.0%

Your Cost: $0.00/claim|Median: $47.08
0.0× median
G9010Normal range

$0

26K claims · 0.0%

Your Cost: $0.00/claim|Median: $1,009.60
3078FNormal range

$0

130 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.08
3079FNormal range

$0

48 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.12
3080FNormal range

$0

22 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.16
3008FNormal range

$0

3K claims · 0.0%

Your Cost: $0.00/claim|Median: $0.06
G9011Normal range

$0

20K claims · 0.0%

Your Cost: $0.00/claim|Median: $39.92
G9007Normal range

$0

41K claims · 0.0%

Your Cost: $0.00/claim|Median: $43.44
3074FNormal range

$0

139 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.11
3075FNormal range

$0

69 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.15
G9006Normal range

Coordination of long-term care services, per hour

$0

54K claims · 0.0%

Your Cost: $0.00/claim|Median: $204.93
A0120Normal range

Non-emergency mini-bus transport

$0

423 claims · 0.0%

Your Cost: $0.00/claim|Median: $16.09
3077FNormal range

$0

27 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.12