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

Samaritan Daytop Village Inc.

Substance Abuse Rehabilitation Facility·Richmond Hill, NY·NPI: 1396822839SharePrint 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:

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 $1,389.41 per claim for H0040 (Assertive community treatment, face-to-face, per 15 minutes) — 5.2× the national median of $266.41.

Bills $115.32 per claim for 99213 (Office/outpatient visit, est. patient, low-mod complexity) — 3.0× the national median of $37.81.

Bills $106.72 per claim for 99212 (Office/outpatient visit, low complexity) — 4.3× the national median of $25.06.

Billing above the 90th percentile for 11 procedure codes simultaneously.

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

Compared to Substance Abuse Rehabilitation Facility Peers

Total spending distribution among 20 providers in this specialty

P25MedianP75P90

This provider's total spending of $191.8M is at the 90th percentile among 20 Substance Abuse Rehabilitation Facility providers.

Above 90th percentile for this specialty — higher spending than 18 of 20 peers

Active Billing Period:2018-012024-09(81 months)

Total Paid

$191.8M

$191,804,343

Total Claims

1.4M

Beneficiaries

311K

4.7 claims/patient

Avg Cost/Claim

$132

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

🔍 Analysis

Provider Overview

Samaritan Daytop Village Inc. is a Substance Abuse Rehabilitation Facility provider based in Richmond Hill, NY. From the 2018–2024 period, this provider received $191.8M in Medicaid payments across 1.4M claims.

Why This Matters

This provider received $191.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 23,975 Medicaid beneficiaries for a full year at average per-enrollee costs.

141% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$10.7M
+42%
2019
$15.2M
+97%
2020
$29.9M
+10%
2021
$33.0M
+7%
2022
$35.4M
+18%
2023
$41.8M
-38%
2024
$25.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (H2036 (Alcohol/drug treatment, per hour)) accounts for 29% of total spending.

H2036Normal range

Alcohol/drug treatment, per hour

$56.6M

366K claims · 29.5%

Your Cost: $154.73/claim|Median: $253.79
0.6× median
G2067Top 10%

Medication-assisted treatment, opioid use disorder, per month

$56.5M

271K claims · 29.5%

Your Cost: $208.81/claim|Median: $73.29
2.9× median
T1040Normal range

Medicaid certified CCBHC services

$46.7M

359K claims · 24.4%

Your Cost: $130.29/claim|Median: $130.29
1.0× median
90832Top 10%

Psychotherapy, 30 minutes

$8.3M

76K claims · 4.3%

Your Cost: $110.30/claim|Median: $41.28
2.7× median
90834Top 5%

Psychotherapy, 45 minutes

$5.3M

36K claims · 2.7%

Your Cost: $145.32/claim|Median: $63.65
2.3× median
H0020Normal range

Alcohol/drug services; methadone administration

$5.2M

190K claims · 2.7%

Your Cost: $27.22/claim|Median: $18.95
1.4× median
90853Top 25%

Group psychotherapy

$4.4M

78K claims · 2.3%

Your Cost: $56.65/claim|Median: $25.02
2.3× median
H0040Top 25%

Assertive community treatment, face-to-face, per 15 minutes

$1.3M

928 claims · 0.7%

Your Cost: $1,389.41/claim|Median: $266.41
5.2× median
90791Top 10%

Psychiatric diagnostic evaluation

$1.2M

6K claims · 0.6%

Your Cost: $185.55/claim|Median: $99.21
1.9× median
S9480Normal range

Intensive outpatient psychiatric services, per diem

$894K

8K claims · 0.5%

Your Cost: $108.42/claim|Median: $135.70
0.8× median
99214Top 5%

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

$848K

6K claims · 0.4%

Your Cost: $131.08/claim|Median: $53.41
2.5× median
99213Top 5%

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

$776K

7K claims · 0.4%

Your Cost: $115.32/claim|Median: $37.81
3.0× median
H0038Normal range

Self-help/peer services, per 15 minutes

$769K

13K claims · 0.4%

Your Cost: $58.62/claim|Median: $55.04
1.1× median
H0001Top 25%

Alcohol and/or drug assessment

$764K

5K claims · 0.4%

Your Cost: $161.26/claim|Median: $94.22
1.7× median
99212Top 5%

Office/outpatient visit, low complexity

$654K

6K claims · 0.3%

Your Cost: $106.72/claim|Median: $25.06
4.3× median
H0004Normal range

Behavioral health counseling & therapy, per 15 min

$368K

7K claims · 0.2%

Your Cost: $49.59/claim|Median: $74.63
0.7× median
99215Top 25%

Office/outpatient visit, high complexity

$294K

2K claims · 0.2%

Your Cost: $121.13/claim|Median: $74.09
1.6× median
99203Top 5%

Office/outpatient visit, new patient, low-mod complexity

$220K

2K claims · 0.1%

Your Cost: $125.16/claim|Median: $57.85
2.2× median
90836Top 10%

Psychotherapy, 45 min, add-on to E/M

$137K

1K claims · 0.1%

Your Cost: $104.62/claim|Median: $56.18
1.9× median
99202Top 10%

Office/outpatient visit, new patient, low complexity

$126K

1K claims · 0.1%

Your Cost: $123.68/claim|Median: $40.11
3.1× median
90846Normal range

Family psychotherapy without patient, 50 min

$85K

835 claims · 0.0%

Your Cost: $101.82/claim|Median: $76.61
1.3× median
H0050Normal range

$80K

2K claims · 0.0%

Your Cost: $50.76/claim|Median: $46.71
1.1× median
90847Top 5%

Family psychotherapy with patient, 50 min

$67K

326 claims · 0.0%

Your Cost: $206.79/claim|Median: $77.33
2.7× median
H2001Normal range

$50K

1K claims · 0.0%

Your Cost: $48.18/claim|Median: $309.28
0.2× median
90833Top 25%

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

$36K

550 claims · 0.0%

Your Cost: $65.61/claim|Median: $38.83
1.7× median
99396Top 25%

Preventive medicine, established patient, age 40-64

$35K

309 claims · 0.0%

Your Cost: $112.95/claim|Median: $76.06
1.5× median
99201Top 25%

Office/outpatient visit, new patient, straightforward

$28K

326 claims · 0.0%

Your Cost: $86.20/claim|Median: $27.38
3.1× median
H0005Normal range

Alcohol and/or drug services, group counseling

$14K

263 claims · 0.0%

Your Cost: $52.12/claim|Median: $47.35
1.1× median
99386Top 25%

Preventive visit, new patient, 40-64 yr

$13K

99 claims · 0.0%

Your Cost: $132.51/claim|Median: $87.82
1.5× median
G2068Normal range

$12K

69 claims · 0.0%

Your Cost: $176.06/claim|Median: $170.60
1.0× median