Mount Rogers Community Services
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 10 procedure codes: H0023 at 6.2× median, T1017 at 5.0× median.
Consistent Billing
Monthly billing amounts show almost no natural variation (CV < 0.1).
Monthly billing coefficient of variation: 0.0889 (near-zero variation).
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
▼
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.
Consistent Billing
Consistent Billing means this provider's monthly billing amounts show almost no natural variation. Real medical practices tend to have some fluctuation in monthly billing, so unnaturally steady billing can indicate automated or fabricated claims.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $337.28 per claim for H0023 (Behavioral health outreach service, per 15 minutes) — 6.3× the national median of $53.97.
Bills $346.10 per claim for T1017 (Targeted case management, per 15 min) — 5.0× the national median of $69.56.
Bills $796.37 per claim for 97150 (Therapeutic procedure, group (2+ patients)) — 65.7× the national median of $12.12.
Billing above the 90th percentile for 8 procedure codes simultaneously.
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
This provider's total spending of $210.4M is at the 50th percentile among 28 Clinic/Center Mental Health (Including Community Mental Health Center) providers.
Total Paid
$210.4M
$210,426,117
Total Claims
1.1M
Beneficiaries
446K
2.4 claims/patient
Avg Cost/Claim
$200
#419 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Mount Rogers Community Services is a Clinic/Center Mental Health (Including Community Mental Health Center) provider based in Wytheville, VA. From the 2018–2024 period, this provider received $210.4M in Medicaid payments across 1.1M claims.
Why This Matters
This provider received $210.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 26,303 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 (H0023 (Behavioral health outreach service, per 15 minutes)) accounts for 26% of total spending.
$55.6M
165K claims
$337.28
$53.97
Behavioral health outreach service, per 15 minutes
$55.6M
165K claims · 26.4%
$24.8M
80K claims
$308.96
$336.31
Community-based wrap-around services, per diem
$24.8M
80K claims · 11.8%
$23.6M
84K claims
$281.42
$1,051.57
Residential care, NOS; per diem
$23.6M
84K claims · 11.2%
$12.1M
126K claims
$95.95
$148.53
Mental health partial hospitalization, treatment, per hour
$12.1M
126K claims · 5.8%
Targeted case management, per 15 min
$12.1M
35K claims · 5.8%
$11.2M
122K claims
$91.57
$85.02
Mental health services, not otherwise specified
$11.2M
122K claims · 5.3%
$10.0M
13K claims
$796.37
$12.12
Therapeutic procedure, group (2+ patients)
$10.0M
13K claims · 4.7%
Psychotherapy, 60 minutes
$7.8M
72K claims · 3.7%
$7.1M
10K claims
$747.03
$392.63
Psychosocial rehabilitation services, per diem
$7.1M
10K claims · 3.4%
$6.7M
14K claims
$465.06
$84.12
Therapeutic behavioral services, per 15 min
$6.7M
14K claims · 3.2%
$5.5M
73K claims
$75.73
$321.53
Comprehensive community support services, per 15 min
$5.5M
73K claims · 2.6%
$4.6M
24K claims
$189.89
$266.41
Assertive community treatment, face-to-face, per 15 minutes
$4.6M
24K claims · 2.2%
$4.0M
5K claims
$770.16
$215.80
Crisis intervention service, per 15 minutes
$4.0M
5K claims · 1.9%
$3.0M
13K claims
$236.13
$129.75
Alcohol and/or drug abuse, intensive outpatient, per hour
$3.0M
13K claims · 1.4%
$2.8M
3K claims
$1,024.24
$132.62
Assertive community treatment, per diem
$2.8M
3K claims · 1.3%
$2.6M
39K claims
$67.04
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$2.6M
39K claims · 1.2%
Case management, per month
$1.7M
13K claims · 0.8%
$1.5M
6K claims
$260.63
$76.05
Community psychiatric supportive treatment, per 15 min
$1.5M
6K claims · 0.7%
Psychiatric diagnostic evaluation
$1.4M
11K claims · 0.7%
$1.4M
16K claims
$88.00
$137.86
Behavioral health day treatment, per hour
$1.4M
16K claims · 0.7%
$1.2M
9K claims
$137.11
$108.91
Psychiatric diagnostic evaluation with medical services
$1.2M
9K claims · 0.6%
$1.2M
3K claims
$412.47
$625.59
Family stabilization services, per 15 minutes
$1.2M
3K claims · 0.5%
Psychotherapy, 30 minutes
$1.1M
19K claims · 0.5%
$907K
4K claims
$239.87
$137.85
Other specified case management service, per 15 minutes
$907K
4K claims · 0.4%
$839K
20K claims
$42.14
$91.63
Psychosocial rehabilitation services, per 15 min
$839K
20K claims · 0.4%
$718K
4K claims
$186.08
$150.51
Day habilitation, waiver; per 15 min
$718K
4K claims · 0.3%
$660K
3K claims
$232.60
$43.10
Alcohol and/or drug services, case management
$660K
3K claims · 0.3%
$615K
7K claims
$92.08
$77.33
Family psychotherapy with patient, 50 min
$615K
7K claims · 0.3%
Psychotherapy, 45 minutes
$604K
8K claims · 0.3%
$565K
2K claims
$313.64
$300.13
Community transition, waiver; per service
$565K
2K claims · 0.3%
Other Top Providers in Virginia
View all →Virginia Commonwealth University Health System Authority
General Acute Care Hospital
$658.5M
Rector & Visitors of the University of Virginia
General Acute Care Hospital
$500.5M
Wall Residences LLC
Community Based Residential Treatment Facility In
$481.6M
Home Care Delivered, Inc.
Durable Medical Equipment & Medical Supplies
$309.5M
Childrens Hospital of the Kings Daughters INC
Social Worker, Clinical
$288.2M
Similar Providers
Other top providers in Clinic/Center Mental Health (Including Community Mental Health Center)