Vermont Department of Mental Health
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code H2022 (1 unique codes).
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:
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Total Paid
$105.1M
$105,147,063
Total Claims
119K
Beneficiaries
113K
1.1 claims/patient
Avg Cost/Claim
$884
🔍 Analysis
Provider Overview
Vermont Department of Mental Health is a Clinic/Center Adult Mental Health provider based in Burlington, VT. From the 2018–2024 period, this provider received $105.1M in Medicaid payments across 119K 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 $105.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 13,143 Medicaid beneficiaries for a full year at average per-enrollee costs.
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