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

Easterseals Morc Health Care, Inc.

Psychiatry & Neurology, Psychiatry·Auburn Hills, MI·NPI: 1376526616SharePrint Report
View on Risk Watchlist →

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:

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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

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Bills $327.30 per claim for S0280 (Medical home program, comprehensive care management) — 6.8× the national median of $48.38.

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Bills $127.84 per claim for T1002 (RN services, per 15 minutes) — 3.4× the national median of $37.42.

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Bills $76.51 per claim for 90853 (Group psychotherapy) — 3.1× the national median of $25.02.

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Billing in the top 1% nationally for 1 procedure code: T1023.

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

Compared to Psychiatry & Neurology, Psychiatry Peers

Total spending distribution among 15 providers in this specialty

P25MedianP75P90

This provider's total spending of $188.3M is at the 99th percentile among 15 Psychiatry & Neurology, Psychiatry providers.

Above 99th percentile for this specialty — higher spending than 14 of 15 peers

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$188.3M

$188,329,379

Total Claims

1.7M

Beneficiaries

948K

1.8 claims/patient

Avg Cost/Claim

$109

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

🔍 Analysis

Provider Overview

Easterseals Morc Health Care, Inc. is a Psychiatry & Neurology, Psychiatry provider based in Auburn Hills, MI. From the 2018–2024 period, this provider received $188.3M in Medicaid payments across 1.7M claims.

Why This Matters

This provider received $188.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 23,541 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 10% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$29.7M
-33%
2019
$19.9M
-11%
2020
$17.8M
+65%
2021
$29.3M
-0%
2022
$29.3M
+1%
2023
$29.6M
+10%
2024
$32.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (T1017 (Targeted case management, per 15 min)) accounts for 24% of total spending.

T1017Normal range

Targeted case management, per 15 min

$44.3M

305K claims · 23.5%

Your Cost: $145.40/claim|Median: $69.56
2.1× median
H0036Top 25%

Community psychiatric supportive treatment, per 15 min

$34.7M

156K claims · 18.4%

Your Cost: $222.77/claim|Median: $76.05
2.9× median
H0039Normal range

Assertive community treatment, per diem

$14.9M

113K claims · 7.9%

Your Cost: $131.78/claim|Median: $132.62
1.0× median
99214Top 10%

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

$10.6M

93K claims · 5.6%

Your Cost: $113.68/claim|Median: $53.41
2.1× median
H0032Top 25%

Mental health service plan development

$9.1M

64K claims · 4.8%

Your Cost: $143.00/claim|Median: $80.64
1.8× median
90834Top 25%

Psychotherapy, 45 minutes

$6.4M

62K claims · 3.4%

Your Cost: $103.08/claim|Median: $63.65
1.6× median
90837Top 10%

Psychotherapy, 60 minutes

$5.8M

39K claims · 3.1%

Your Cost: $147.36/claim|Median: $85.66
1.7× median
H0031Top 10%

Mental health assessment by non-physician

$4.8M

19K claims · 2.6%

Your Cost: $249.21/claim|Median: $96.18
2.6× median
90792Top 10%

Psychiatric diagnostic evaluation with medical services

$4.1M

15K claims · 2.2%

Your Cost: $269.52/claim|Median: $108.91
2.5× median
99213Top 5%

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

$4.1M

37K claims · 2.2%

Your Cost: $112.05/claim|Median: $37.81
3.0× median
S0280Top 5%

Medical home program, comprehensive care management

$4.1M

12K claims · 2.2%

Your Cost: $327.30/claim|Median: $48.38
6.8× median
T1040Normal range

Medicaid certified CCBHC services

$3.9M

424K claims · 2.1%

Your Cost: $9.31/claim|Median: $130.29
0.1× median
T1002Top 25%

RN services, per 15 minutes

$3.9M

30K claims · 2.1%

Your Cost: $127.84/claim|Median: $37.42
3.4× median
90853Top 10%

Group psychotherapy

$3.4M

44K claims · 1.8%

Your Cost: $76.51/claim|Median: $25.02
3.1× median
90791Top 25%

Psychiatric diagnostic evaluation

$3.1M

23K claims · 1.6%

Your Cost: $136.93/claim|Median: $99.21
1.4× median
90832Top 25%

Psychotherapy, 30 minutes

$3.0M

40K claims · 1.6%

Your Cost: $74.98/claim|Median: $41.28
1.8× median
90847Top 25%

Family psychotherapy with patient, 50 min

$2.5M

19K claims · 1.3%

Your Cost: $130.37/claim|Median: $77.33
1.7× median
H0038Top 25%

Self-help/peer services, per 15 minutes

$2.3M

19K claims · 1.2%

Your Cost: $121.23/claim|Median: $55.04
2.2× median
97153Normal range

Adaptive behavior treatment by protocol, per 15 min

$2.2M

26K claims · 1.1%

Your Cost: $84.30/claim|Median: $167.38
0.5× median
H2016Normal range

Comprehensive community support services, per 15 min

$2.0M

7K claims · 1.1%

Your Cost: $295.64/claim|Median: $321.53
0.9× median
96372Top 5%

Therapeutic injection, subcutaneous/intramuscular

$1.9M

28K claims · 1.0%

Your Cost: $65.80/claim|Median: $9.56
6.9× median
H2023Top 25%

Supported employment, per 15 min

$1.8M

10K claims · 1.0%

Your Cost: $185.29/claim|Median: $103.94
1.8× median
H2022Normal range

Community-based wrap-around services, per diem

$1.5M

4K claims · 0.8%

Your Cost: $383.05/claim|Median: $336.31
1.1× median
T1005Normal range

Respite care services, per 15 minutes

$1.4M

14K claims · 0.7%

Your Cost: $102.80/claim|Median: $71.40
1.4× median
T1020Normal range

Personal care services, per diem

$1.4M

7K claims · 0.7%

Your Cost: $202.24/claim|Median: $296.27
0.7× median
T1023Top 1%

Screening to determine appropriateness of consideration for program

$1.1M

945 claims · 0.6%

Your Cost: $1,204.54/claim|Median: $106.70
11.3× median
H2011Normal range

Crisis intervention service, per 15 minutes

$1.1M

3K claims · 0.6%

Your Cost: $357.82/claim|Median: $215.80
1.7× median
S5111Top 5%

Home care training, family member, per session

$925K

3K claims · 0.5%

Your Cost: $322.33/claim|Median: $87.13
3.7× median
0365TNormal range

Adaptive behavior treatment, each additional thirty minutes

$739K

5K claims · 0.4%

Your Cost: $152.99/claim|Median: $106.05
1.4× median
99212Top 5%

Office/outpatient visit, low complexity

$727K

6K claims · 0.4%

Your Cost: $113.21/claim|Median: $25.06
4.5× median

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