Contra Costa County
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $322.45 per claim for H2017 (Psychosocial rehabilitation services, per 15 min), which is 3.5× the national median of $91.63.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 43 procedure codes: H2017 at 3.5× median, H2019 at 4.8× 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:
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.
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 $322.45 per claim for H2017 (Psychosocial rehabilitation services, per 15 min) — 3.5× the national median of $91.63.
Bills $231.58 per claim for T1017 (Targeted case management, per 15 min) — 3.3× the national median of $69.56.
Bills $406.74 per claim for H2019 (Therapeutic behavioral services, per 15 min) — 4.8× the national median of $84.12.
Billing in the top 1% nationally for 9 procedure codes: 90837, 90834, 99233.
This is a statistical summary, not an accusation. See our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $537.0M is at the 90th percentile among 156 General Acute Care Hospital providers.
Above 90th percentile for this specialty — higher spending than 140 of 156 peers
Total Paid
$537.0M
$536,975,608
Total Claims
3.2M
Beneficiaries
635K
5.0 claims/patient
Avg Cost/Claim
$169
#108 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Contra Costa County is a General Acute Care Hospital provider based in Martinez, CA. From the 2018–2024 period, this provider received $537.0M in Medicaid payments across 3.2M claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $537.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 67,121 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 28% of total spending.
$150.9M
661K claims
$228.42
$96.24
Comprehensive community support services, per 15 min
$150.9M
661K claims · 28.1%
$74.6M
231K claims
$322.45
$91.63
Psychosocial rehabilitation services, per 15 min
$74.6M
231K claims · 13.9%
$49.4M
213K claims
$231.58
$69.56
Targeted case management, per 15 min
$49.4M
213K claims · 9.2%
$35.6M
123K claims
$288.71
$357.16
Behavioral health; residential, per diem
$35.6M
123K claims · 6.6%
$26.2M
64K claims
$406.74
$84.12
Therapeutic behavioral services, per 15 min
$26.2M
64K claims · 4.9%
Psychotherapy, 60 minutes
$20.7M
55K claims · 3.9%
$20.1M
1.3M claims
$15.39
$18.95
Alcohol/drug services; methadone administration
$20.1M
1.3M claims · 3.7%
$19.1M
11K claims
$1,776.29
$249.51
Crisis intervention mental health services, per hour
$19.1M
11K claims · 3.6%
$18.6M
64K claims
$290.01
$80.64
Mental health service plan development
$18.6M
64K claims · 3.5%
$17.3M
38K claims
$451.70
$467.51
Behavioral health; short-term residential, per diem
$17.3M
38K claims · 3.2%
$10.6M
36K claims
$294.77
$72.96
Prolonged office/outpatient E/M, each additional 15 min
$10.6M
36K claims · 2.0%
$10.0M
88K claims
$114.68
$74.63
Behavioral health counseling & therapy, per 15 min
$10.0M
88K claims · 1.9%
$6.8M
65K claims
$104.18
$129.75
Alcohol and/or drug abuse, intensive outpatient, per hour
$6.8M
65K claims · 1.3%
Psychotherapy, 45 minutes
$6.8M
24K claims · 1.3%
$6.5M
5K claims
$1,371.71
$35.30
Subsequent hospital care, per day, high complexity
$6.5M
5K claims · 1.2%
$6.2M
6K claims
$1,028.22
$74.09
Office/outpatient visit, high complexity
$6.2M
6K claims · 1.2%
$6.1M
34K claims
$177.89
$62.69
Comprehensive medication services, per 15 min
$6.1M
34K claims · 1.1%
$6.0M
6K claims
$1,007.51
$23.99
Subsequent hospital care, per day, moderate complexity
$6.0M
6K claims · 1.1%
$4.9M
5K claims
$1,004.15
$215.80
Crisis intervention service, per 15 minutes
$4.9M
5K claims · 0.9%
$4.7M
32K claims
$145.97
$47.35
Alcohol and/or drug services, group counseling
$4.7M
32K claims · 0.9%
$4.5M
12K claims
$390.74
$96.18
Mental health assessment by non-physician
$4.5M
12K claims · 0.8%
$4.5M
7K claims
$627.63
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$4.5M
7K claims · 0.8%
$3.0M
7K claims · 0.6%
$2.5M
8K claims
$329.35
$77.33
Family psychotherapy with patient, 50 min
$2.5M
8K claims · 0.5%
Day habilitation, waiver; per 15 min
$2.5M
6K claims · 0.5%
$2.2M
4K claims
$485.61
$169.11
Community-based wrap-around services, per 15 min
$2.2M
4K claims · 0.4%
$2.1M
4K claims
$507.46
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$2.1M
4K claims · 0.4%
$1.9M
972 claims
$1,975.71
$67.32
Initial hospital care, per day, high complexity
$1.9M
972 claims · 0.4%
$1.8M
2K claims
$1,033.53
$259.38
Supported employment, waiver, per diem
$1.8M
2K claims · 0.3%
$1.5M
10K claims
$150.06
$9.56
Therapeutic injection, subcutaneous/intramuscular
$1.5M
10K claims · 0.3%
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