New York Psychotherapy and Counseling Center
Billing Swing
Experienced over 200% change in year-over-year billing with >$1M absolute change.
Billing changed from $774K (2018) to $14.5M (2019) — a 1774% swing with $13.7M absolute change.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 9 procedure codes: 90832 at 2.7× median, 90834 at 2.3× median.
Explosive Growth
Billing increased over 500% year-over-year — far beyond normal growth patterns.
Billing grew 1774% from 2018 to 2019.
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:
Billing Swing
Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.
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.
Explosive Growth
Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $114.23 per claim for 99212 (Office/outpatient visit, low complexity) — 4.6× the national median of $25.06.
Billing above the 90th percentile for 9 procedure codes simultaneously.
This is a statistical summary, not an accusation. See our methodology.
Compared to Community/Behavioral Health Peers
Total spending distribution among 218 providers in this specialty
This provider's total spending of $304.0M is at the 90th percentile among 218 Community/Behavioral Health providers.
Above 90th percentile for this specialty — higher spending than 196 of 218 peers
Total Paid
$304.0M
$303,978,534
Total Claims
3.1M
Beneficiaries
1.5M
2.0 claims/patient
Avg Cost/Claim
$99
#239 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
New York Psychotherapy and Counseling Center is a Community/Behavioral Health provider based in Jamaica, NY. From the 2018–2024 period, this provider received $304.0M in Medicaid payments across 3.1M claims.
Why This Matters
This provider received $304.0M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 37,997 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 18 distinct procedure codes. The top code (90832 (Psychotherapy, 30 minutes)) accounts for 53% of total spending.
Psychotherapy, 30 minutes
$161.6M
1.5M claims · 53.2%
Psychotherapy, 45 minutes
$65.8M
459K claims · 21.7%
$19.7M
172K claims
$114.23
$25.06
Office/outpatient visit, low complexity
$19.7M
172K claims · 6.5%
$17.8M
161K claims
$110.78
$76.61
Family psychotherapy without patient, 50 min
$17.8M
161K claims · 5.9%
Psychiatric diagnostic evaluation
$13.2M
72K claims · 4.3%
$8.2M
78K claims
$104.14
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$8.2M
78K claims · 2.7%
$7.1M
541K claims · 2.3%
$3.0M
14K claims
$218.23
$77.33
Family psychotherapy with patient, 50 min
$3.0M
14K claims · 1.0%
$2.0M
17K claims
$115.21
$57.85
Office/outpatient visit, new patient, low-mod complexity
$2.0M
17K claims · 0.7%
$1.7M
30K claims
$55.43
$22.44
Telephone E/M by physician, 11-20 minutes
$1.7M
30K claims · 0.5%
$1.4M
27K claims
$53.98
$137.86
Behavioral health day treatment, per hour
$1.4M
27K claims · 0.5%
$935K
3K claims
$291.98
$108.91
Psychiatric diagnostic evaluation with medical services
$935K
3K claims · 0.3%
Psychotherapy, 45 min, add-on to E/M
$750K
8K claims · 0.2%
$589K
10K claims
$61.43
$38.83
Psychotherapy, 30 min, add-on to E/M service
$589K
10K claims · 0.2%
$169K
1K claims
$160.41
$215.80
Crisis intervention service, per 15 minutes
$169K
1K claims · 0.1%
$43K
402 claims
$107.24
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$43K
402 claims · 0.0%
$412
13 claims
$31.65
$32.55
Telephone E/M by physician, 21-30 min
$412
13 claims · 0.0%
$0
27 claims
$0.00
$67.32
Initial hospital care, per day, high complexity
$0
27 claims · 0.0%
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