Beacon Specialized Living Services Inc.
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $1,233.02 per claim for H2016 (Comprehensive community support services, per 15 min), which is 3.8× the national median of $321.53.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 14 procedure codes: 99212 at 8.0× median, 99213 at 4.9× 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 $1,233.02 per claim for H2016 (Comprehensive community support services, per 15 min) — 3.8× the national median of $321.53.
Bills $201.15 per claim for 99212 (Office/outpatient visit, low complexity) — 8.0× the national median of $25.06.
Bills $171.89 per claim for T1016 (Case management, each 15 min) — 3.5× the national median of $49.62.
Billing in the top 1% nationally for 3 procedure codes: 99213, 99214, 96372.
This is a statistical summary, not an accusation. See our methodology.
Compared to Residential Treatment Facility Intellectual and/or Developmental Disabilities Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $302.4M is at the 99th percentile among 8 Residential Treatment Facility Intellectual and/or Developmental Disabilities providers.
Above 99th percentile for this specialty — higher spending than 7 of 8 peers
Total Paid
$302.4M
$302,447,891
Total Claims
412K
Beneficiaries
73K
5.7 claims/patient
Avg Cost/Claim
$734
#241 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Beacon Specialized Living Services Inc. is a Residential Treatment Facility Intellectual and/or Developmental Disabilities provider based in Bangor, MI. From the 2018–2024 period, this provider received $302.4M in Medicaid payments across 412K claims.
Why This Matters
This provider received $302.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 37,805 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 29 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 75% of total spending.
$225.7M
183K claims
$1,233.02
$321.53
Comprehensive community support services, per 15 min
$225.7M
183K claims · 74.6%
$64.5M
180K claims
$359.10
$296.27
Personal care services, per diem
$64.5M
180K claims · 21.3%
Supported housing, per diem
$5.3M
14K claims · 1.8%
$3.0M
13K claims
$235.60
$96.24
Comprehensive community support services, per 15 min
$3.0M
13K claims · 1.0%
$2.4M
3K claims
$896.55
$467.51
Behavioral health; short-term residential, per diem
$2.4M
3K claims · 0.8%
$763K
9K claims
$80.81
$69.56
Targeted case management, per 15 min
$763K
9K claims · 0.3%
$170K
6K claims · 0.1%
$136K
675 claims
$201.15
$25.06
Office/outpatient visit, low complexity
$136K
675 claims · 0.0%
Case management, each 15 min
$66K
385 claims · 0.0%
$58K
636 claims
$90.58
$114.71
Comprehensive multidisciplinary evaluation
$58K
636 claims · 0.0%
$55K
403 claims
$136.78
$73.58
Mental health clubhouse services, per 15 minutes
$55K
403 claims · 0.0%
$47K
239 claims
$194.77
$132.62
Assertive community treatment, per diem
$47K
239 claims · 0.0%
$27K
147 claims
$186.88
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$27K
147 claims · 0.0%
Mental health service plan development
$24K
67 claims · 0.0%
$24K
109 claims
$222.52
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$24K
109 claims · 0.0%
$24K
502 claims
$47.36
$83.88
Skills training & development, per 15 min
$24K
502 claims · 0.0%
$20K
51 claims
$389.71
$76.05
Community psychiatric supportive treatment, per 15 min
$20K
51 claims · 0.0%
RN services, per 15 minutes
$17K
62 claims · 0.0%
$16K
43 claims
$372.41
$96.18
Mental health assessment by non-physician
$16K
43 claims · 0.0%
Psychotherapy, 45 minutes
$15K
124 claims · 0.0%
$11K
81 claims
$131.92
$9.56
Therapeutic injection, subcutaneous/intramuscular
$11K
81 claims · 0.0%
$10K
40 claims
$256.00
$55.04
Self-help/peer services, per 15 minutes
$10K
40 claims · 0.0%
$7K
20 claims
$370.50
$215.80
Crisis intervention service, per 15 minutes
$7K
20 claims · 0.0%
Group psychotherapy
$7K
70 claims · 0.0%
$7K
42 claims
$160.00
$77.33
Family psychotherapy with patient, 50 min
$7K
42 claims · 0.0%
Psychotherapy, 30 minutes
$6K
89 claims · 0.0%
Psychotherapy, 60 minutes
$6K
37 claims · 0.0%
Non-emergency transport; encounter/trip
$2K
13 claims · 0.0%
$960
12 claims · 0.0%
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