State of Missouri
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: H0031 at 6.4× median, 99204 at 2.0× 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:
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 $616.27 per claim for H0031 (Mental health assessment by non-physician) — 6.4× the national median of $96.18.
Billing above the 90th percentile for 2 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$493.6M
$493,553,307
Total Claims
3.3M
Beneficiaries
846K
3.9 claims/patient
Avg Cost/Claim
$148
#125 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
State of Missouri is a Psychologist, Rehabilitation provider based in Jefferson City, MO. From the 2018–2024 period, this provider received $493.6M in Medicaid payments across 3.3M 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 $493.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 61,694 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 20 distinct procedure codes. The top code (H0036 (Community psychiatric supportive treatment, per 15 min)) accounts for 42% of total spending.
$206.6M
1.4M claims
$144.94
$76.05
Community psychiatric supportive treatment, per 15 min
$206.6M
1.4M claims · 41.9%
$187.9M
686K claims
$274.06
$225.50
Community psychiatric supportive treatment program, per diem
$187.9M
686K claims · 38.1%
$44.9M
714K claims
$62.86
$91.63
Psychosocial rehabilitation services, per 15 min
$44.9M
714K claims · 9.1%
$26.0M
42K claims
$616.27
$96.18
Mental health assessment by non-physician
$26.0M
42K claims · 5.3%
$7.2M
167K claims
$43.32
$62.69
Comprehensive medication services, per 15 min
$7.2M
167K claims · 1.5%
$5.0M
56K claims
$88.08
$74.63
Behavioral health counseling & therapy, per 15 min
$5.0M
56K claims · 1.0%
$4.4M
58K claims
$76.49
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$4.4M
58K claims · 0.9%
$3.0M
19K claims
$158.45
$266.41
Assertive community treatment, face-to-face, per 15 minutes
$3.0M
19K claims · 0.6%
$2.9M
27K claims
$109.99
$55.04
Self-help/peer services, per 15 minutes
$2.9M
27K claims · 0.6%
$1.1M
44K claims
$25.20
$36.25
Behavioral health prevention education, per session
$1.1M
44K claims · 0.2%
Behavioral health screening
$1.1M
19K claims · 0.2%
$1.0M
24K claims
$42.98
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$1.0M
24K claims · 0.2%
$917K
30K claims
$30.40
$47.35
Alcohol and/or drug services, group counseling
$917K
30K claims · 0.2%
$813K
5K claims
$161.23
$108.91
Psychiatric diagnostic evaluation with medical services
$813K
5K claims · 0.2%
$266K
5K claims
$57.24
$36.49
Office consultation, straightforward
$266K
5K claims · 0.1%
$227K
5K claims
$44.01
$80.64
Mental health service plan development
$227K
5K claims · 0.0%
$80K
612 claims
$129.90
$74.09
Office/outpatient visit, high complexity
$80K
612 claims · 0.0%
$35K
208 claims
$168.60
$84.03
Office/outpatient visit, new patient, mod-high complexity
$35K
208 claims · 0.0%
$11K
281 claims
$38.71
$25.06
Office/outpatient visit, low complexity
$11K
281 claims · 0.0%
$11K
76 claims
$142.95
$215.80
Crisis intervention service, per 15 minutes
$11K
76 claims · 0.0%