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Department of Behavioral Health

Social Worker, Clinical·Fresno, CA·NPI: 1629137575Share

Compared to Social Worker, Clinical Peers

Total spending distribution among 34 providers in this specialty

P25MedianP75P90

This provider's total spending of $166.3M is at the 90th percentile among 34 Social Worker, Clinical providers.

Above 90th percentile for this specialty — higher spending than 30 of 34 peers

Active Billing Period:2018-01→2024-06(78 months)

Total Paid

$166.3M

$166,252,392

Total Claims

3.9M

Beneficiaries

344K

11.4 claims/patient

Avg Cost/Claim

$42

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

🔍 Analysis

Provider Overview

Department of Behavioral Health is a Social Worker, Clinical provider based in Fresno, CA. From the 2018–2024 period, this provider received $166.3M in Medicaid payments across 3.9M 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 $166.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 20,781 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 60% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$15.7M
+42%
2019
$22.3M
-16%
2020
$18.6M
+18%
2021
$21.9M
+11%
2022
$24.3M
+58%
2023
$38.5M
-35%
2024
$25.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 24 distinct procedure codes. The top code (H0004 (Behavioral health counseling & therapy, per 15 min)) accounts for 32% of total spending.

H0004Top 10%

Behavioral health counseling & therapy, per 15 min

$53.0M

362K claims · 31.9%

Your Cost: $146.23/claim|Median: $74.63
2.0× median
H0020Normal range

Alcohol/drug services; methadone administration

$45.6M

3.0M claims · 27.4%

Your Cost: $15.38/claim|Median: $18.95
0.8× median
H0019Normal range

Behavioral health; residential, per diem

$42.7M

258K claims · 25.7%

Your Cost: $165.24/claim|Median: $357.16
0.5× median
H0005Normal range

Alcohol and/or drug services, group counseling

$12.9M

224K claims · 7.7%

Your Cost: $57.35/claim|Median: $47.35
1.2× median
H0006Top 10%

Alcohol and/or drug services, case management

$4.2M

27K claims · 2.5%

Your Cost: $154.81/claim|Median: $43.10
3.6× median
S5000Top 25%

Prescription drug, generic

$1.5M

51K claims · 0.9%

Your Cost: $30.25/claim|Median: $7.47
4.0× median
T1017Top 10%

Targeted case management, per 15 min

$1.5M

5K claims · 0.9%

Your Cost: $284.92/claim|Median: $69.56
4.1× median
G0397Top 10%

$1.4M

4K claims · 0.8%

Your Cost: $316.93/claim|Median: $142.31
2.2× median
H0012Normal range

$879K

5K claims · 0.5%

Your Cost: $179.22/claim|Median: $295.95
0.6× median
S5001Normal range

$871K

27K claims · 0.5%

Your Cost: $32.81/claim|Median: $17.91
1.8× median
H2017Top 25%

Psychosocial rehabilitation services, per 15 min

$775K

3K claims · 0.5%

Your Cost: $233.57/claim|Median: $91.63
2.5× median
H0001Top 25%

Alcohol and/or drug assessment

$375K

2K claims · 0.2%

Your Cost: $182.81/claim|Median: $94.22
1.9× median
T1007Top 5%

Alcohol/drug services, treatment plan review

$307K

978 claims · 0.2%

Your Cost: $314.05/claim|Median: $64.10
4.9× median
H0007Normal range

$84K

264 claims · 0.1%

Your Cost: $319.68/claim|Median: $71.08
4.5× median
H0015Normal range

Alcohol and/or drug abuse, intensive outpatient, per hour

$79K

2K claims · 0.0%

Your Cost: $41.36/claim|Median: $129.75
0.3× median
H2035Top 10%

Alcohol and/or drug treatment, per hour

$53K

162 claims · 0.0%

Your Cost: $326.38/claim|Median: $94.63
3.5× median
H2027Top 25%

Psychoeducational service, per 15 minutes

$31K

100 claims · 0.0%

Your Cost: $311.16/claim|Median: $82.72
3.8× median
H2014Top 5%

Skills training & development, per 15 min

$28K

49 claims · 0.0%

Your Cost: $568.00/claim|Median: $83.88
6.8× median
G2212Normal range

Prolonged office/outpatient E/M, each additional 15 min

$26K

161 claims · 0.0%

Your Cost: $163.92/claim|Median: $72.96
2.3× median
90885Normal range

$19K

644 claims · 0.0%

Your Cost: $28.90/claim|Median: $59.45
0.5× median
H0050Top 5%

$19K

113 claims · 0.0%

Your Cost: $164.20/claim|Median: $46.71
3.5× median
H0049Top 1%

$7K

15 claims · 0.0%

Your Cost: $448.81/claim|Median: $9.27
48.4× median
90791Top 10%

Psychiatric diagnostic evaluation

$5K

25 claims · 0.0%

Your Cost: $189.13/claim|Median: $99.21
1.9× median
G0396Top 25%

Alcohol/substance abuse structured assessment, 15-30 minutes

$2K

15 claims · 0.0%

Your Cost: $101.18/claim|Median: $40.58
2.5× median

Other Top Providers in California

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Los Angeles County Department of Mental Health

Clinic/Center, Mental Health (Including Community

$6.78B

County of Santa Clara

Community/Behavioral Health

$1.73B

County of Riverside

Community/Behavioral Health

$1.40B

City & County of San Francisco

Community/Behavioral Health

$1.34B

Los Angeles County Department of Public Health

Public Health or Welfare

$1.13B

Similar Providers

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Norfolk, VA

$288.2M

Integrated Services for Behavioral Health

Nelsonville, OH

$131.8M

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