Helen Ross Mcnabb Center
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $154.09 per claim for S0280 (Medical home program, comprehensive care management), which is 3.2× the national median of $48.38.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: H2015 at 9.0× median, H2020 at 13.3× 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 $154.09 per claim for S0280 (Medical home program, comprehensive care management) — 3.2× the national median of $48.38.
Bills $2,816.58 per claim for H0019 (Behavioral health; residential, per diem) — 7.9× the national median of $357.16.
Bills $867.22 per claim for H2015 (Comprehensive community support services, per 15 min) — 9.0× the national median of $96.24.
Billing in the top 1% nationally for 1 procedure code: H2015.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center Mental Health (Including Community Mental Health Center) Peers
Total spending distribution among 28 providers in this specialty
This provider's total spending of $198.8M is at the 50th percentile among 28 Clinic/Center Mental Health (Including Community Mental Health Center) providers.
Total Paid
$198.8M
$198,849,836
Total Claims
2.7M
Beneficiaries
1.6M
1.7 claims/patient
Avg Cost/Claim
$74
#461 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Helen Ross Mcnabb Center is a Clinic/Center Mental Health (Including Community Mental Health Center) provider based in Knoxville, TN. From the 2018–2024 period, this provider received $198.8M in Medicaid payments across 2.7M claims.
Why This Matters
This provider received $198.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,856 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 (S0280 (Medical home program, comprehensive care management)) accounts for 41% of total spending.
$80.7M
524K claims
$154.09
$48.38
Medical home program, comprehensive care management
$80.7M
524K claims · 40.6%
Psychotherapy, 45 minutes
$32.2M
494K claims · 16.2%
$18.1M
205K claims
$88.33
$225.50
Community psychiatric supportive treatment program, per diem
$18.1M
205K claims · 9.1%
Supported housing, per diem
$12.2M
132K claims · 6.1%
$8.9M
3K claims
$2,816.58
$357.16
Behavioral health; residential, per diem
$8.9M
3K claims · 4.5%
$7.6M
201K claims
$37.69
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$7.6M
201K claims · 3.8%
$7.3M
75K claims
$97.41
$321.53
Comprehensive community support services, per 15 min
$7.3M
75K claims · 3.7%
$4.5M
86K claims
$51.81
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$4.5M
86K claims · 2.3%
$3.8M
4K claims
$867.22
$96.24
Comprehensive community support services, per 15 min
$3.8M
4K claims · 1.9%
$3.7M
56K claims
$64.99
$77.33
Family psychotherapy with patient, 50 min
$3.7M
56K claims · 1.8%
$3.6M
2K claims
$1,915.93
$144.05
Day habilitation, waiver, per 15 minutes
$3.6M
2K claims · 1.8%
$3.3M
41K claims
$80.75
$99.21
Psychiatric diagnostic evaluation
$3.3M
41K claims · 1.7%
$3.0M
378 claims
$8,002.28
$1,437.23
Behavioral health; long-term residential, per diem
$3.0M
378 claims · 1.5%
$1.8M
22K claims
$81.85
$108.91
Psychiatric diagnostic evaluation with medical services
$1.8M
22K claims · 0.9%
Crisis intervention, per 15 min
$1.6M
4K claims · 0.8%
Psychotherapy, 30 minutes
$1.6M
40K claims · 0.8%
Psychotherapy, 60 minutes
$1.5M
16K claims · 0.7%
$866K
1K claims
$623.94
$216.31
Foster care, therapeutic, child, per diem
$866K
1K claims · 0.4%
$841K
14K claims
$58.60
$76.61
Family psychotherapy without patient, 50 min
$841K
14K claims · 0.4%
$726K
14K claims
$51.80
$91.63
Psychosocial rehabilitation services, per 15 min
$726K
14K claims · 0.4%
$574K
19K claims
$29.97
$25.06
Office/outpatient visit, low complexity
$574K
19K claims · 0.3%
$413K
2K claims
$193.68
$182.66
Alcohol or drug abuse services, prenatal
$413K
2K claims · 0.2%
Group psychotherapy
$97K
5K claims · 0.0%
$22K
3K claims · 0.0%
$18K
905 claims · 0.0%
$13K
139 claims
$91.21
$392.63
Psychosocial rehabilitation services, per diem
$13K
139 claims · 0.0%
$11K
226 claims
$49.05
$114.71
Comprehensive multidisciplinary evaluation
$11K
226 claims · 0.0%
$11K
243 claims
$45.09
$74.09
Office/outpatient visit, high complexity
$11K
243 claims · 0.0%
$9K
66 claims
$136.82
$31.37
Oral medication administration, direct observation
$9K
66 claims · 0.0%
$4K
133 claims
$30.68
$55.04
Self-help/peer services, per 15 minutes
$4K
133 claims · 0.0%
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