Jersey City Medical Center
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 132 procedure codes: 99283 at 8.7× median, G0378 at 8.1× 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 $370.04 per claim for 99283 (Emergency dept visit, moderate complexity) — 8.7× the national median of $42.48.
Bills $803.23 per claim for G0378 (Hospital observation service, per hour) — 8.1× the national median of $99.39.
Bills $401.91 per claim for 99284 (Emergency dept visit, high complexity) — 5.8× the national median of $69.51.
Billing in the top 1% nationally for 4 procedure codes: 99283, 43239, 93306.
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 $336.4M is at the 75th percentile among 156 General Acute Care Hospital providers.
Total Paid
$336.4M
$336,381,756
Total Claims
3.2M
Beneficiaries
2.4M
1.3 claims/patient
Avg Cost/Claim
$106
#206 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Jersey City Medical Center is a General Acute Care Hospital provider based in Jersey City, NJ. From the 2018–2024 period, this provider received $336.4M in Medicaid payments across 3.2M claims.
Why This Matters
This provider received $336.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 42,047 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 (99283 (Emergency dept visit, moderate complexity)) accounts for 11% of total spending.
$37.0M
100K claims
$370.04
$42.48
Emergency dept visit, moderate complexity
$37.0M
100K claims · 11.0%
$32.1M
40K claims
$803.23
$99.39
Hospital observation service, per hour
$32.1M
40K claims · 9.5%
$31.9M
79K claims
$401.91
$69.51
Emergency dept visit, high complexity
$31.9M
79K claims · 9.5%
$30.0M
56K claims
$535.08
$85.65
Emergency dept visit, high/urgent complexity
$30.0M
56K claims · 8.9%
Ambulance, BLS emergency transport
$29.6M
99K claims · 8.8%
$21.0M
78K claims
$270.21
$148.53
Mental health partial hospitalization, treatment, per hour
$21.0M
78K claims · 6.2%
$12.4M
28K claims
$448.43
$164.22
Ambulance, ALS emergency transport Level 1
$12.4M
28K claims · 3.7%
$7.8M
10K claims
$756.67
$135.70
Intensive outpatient psychiatric services, per diem
$7.8M
10K claims · 2.3%
Emergency dept visit, low complexity
$7.4M
29K claims · 2.2%
$5.7M
8K claims · 1.7%
$4.8M
190K claims
$25.08
$1.68
Orthotic or prosthetic procedure, not otherwise classified
$4.8M
190K claims · 1.4%
Upper GI endoscopy with biopsy
$4.5M
3K claims · 1.3%
$3.7M
5K claims
$697.91
$54.68
Echocardiography, transthoracic, complete, with Doppler
$3.7M
5K claims · 1.1%
Crisis intervention, per 15 min
$3.5M
4K claims · 1.0%
Colonoscopy with biopsy
$3.1M
2K claims · 0.9%
CT abdomen and pelvis with contrast
$2.8M
14K claims · 0.8%
$2.5M
5K claims · 0.7%
$2.3M
7K claims
$344.69
$48.25
Direct admission to hospital observation
$2.3M
7K claims · 0.7%
$2.1M
20K claims · 0.6%
$2.1M
21K claims · 0.6%
$2.0M
121K claims
$16.39
$23.36
Ground mileage, per statute mile
$2.0M
121K claims · 0.6%
$1.9M
36K claims
$51.79
$12.93
Office/outpatient visit, minimal complexity
$1.9M
36K claims · 0.6%
$1.9M
10K claims · 0.6%
CT head/brain without contrast
$1.8M
17K claims · 0.5%
$1.8M
52K claims
$35.11
$33.11
Therapeutic activities, each 15 min
$1.8M
52K claims · 0.5%
$1.8M
29K claims
$61.41
$38.92
IV infusion, hydration, each additional hour
$1.8M
29K claims · 0.5%
$1.8M
27K claims
$65.75
$49.45
Speech/hearing/language treatment
$1.8M
27K claims · 0.5%
$1.7M
43K claims
$39.71
$9.56
Therapeutic injection, subcutaneous/intramuscular
$1.7M
43K claims · 0.5%
$1.7M
71K claims
$23.76
$24.49
Therapeutic exercises, each 15 min
$1.7M
71K claims · 0.5%
$1.7M
922 claims
$1,837.56
$183.33
Left heart catheterization with imaging
$1.7M
922 claims · 0.5%
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