Cornell Scott Hill Health Corporation
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 9 procedure codes: G0511 at 4.7× median, G2025 at 3.7× 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
▼
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 $53.78 per claim for G0511 (RHC/FQHC visit, psychiatric collaborative care model) — 4.7× the national median of $11.35.
Bills $57.82 per claim for G2025 — 3.7× the national median of $15.63.
Bills $27.00 per claim for 11721 — 3.1× the national median of $8.56.
Billing in the top 1% nationally for 2 procedure codes: G0071, G2012.
This is a statistical summary, not an accusation. See our methodology.
Total Paid
$294.2M
$294,234,309
Total Claims
3.9M
Beneficiaries
2.7M
1.5 claims/patient
Avg Cost/Claim
$76
#253 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Cornell Scott Hill Health Corporation is a Psychiatry & Neurology, Child & Adolescent Psychiatry provider based in New Haven, CT. From the 2018–2024 period, this provider received $294.2M in Medicaid payments across 3.9M claims.
Why This Matters
This provider received $294.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 36,779 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 (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 92% of total spending.
$269.7M
1.7M claims
$154.54
$121.16
Clinic visit/encounter, all-inclusive
$269.7M
1.7M claims · 91.7%
$7.5M
17K claims
$448.75
$317.54
Alcohol and/or drug services, acute detoxification, per diem
$7.5M
17K claims · 2.5%
$3.8M
70K claims
$53.78
$11.35
RHC/FQHC visit, psychiatric collaborative care model
$3.8M
70K claims · 1.3%
Psychotherapy, 30 minutes
$3.2M
343K claims · 1.1%
$3.0M
393K claims
$7.65
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$3.0M
393K claims · 1.0%
$1.6M
177K claims
$9.02
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$1.6M
177K claims · 0.5%
$1.0M
30K claims
$34.85
$45.95
Chronic care management services, FQHC/RHC
$1.0M
30K claims · 0.4%
Psychotherapy, 45 minutes
$725K
72K claims · 0.2%
$591K
10K claims · 0.2%
$534K
58K claims
$9.27
$22.44
Telephone E/M by physician, 11-20 minutes
$534K
58K claims · 0.2%
$520K
51K claims
$10.27
$21.91
Federally qualified health center visit, mental health
$520K
51K claims · 0.2%
$342K
256K claims
$1.33
$18.95
Alcohol/drug services; methadone administration
$342K
256K claims · 0.1%
$340K
41K claims
$8.20
$25.06
Office/outpatient visit, low complexity
$340K
41K claims · 0.1%
$304K
11K claims · 0.1%
$198K
29K claims
$6.87
$12.93
Office/outpatient visit, minimal complexity
$198K
29K claims · 0.1%
$100K
16K claims
$6.33
$32.55
Telephone E/M by physician, 21-30 min
$100K
16K claims · 0.0%
$89K
9K claims
$9.81
$9.56
Therapeutic injection, subcutaneous/intramuscular
$89K
9K claims · 0.0%
$84K
8K claims
$10.34
$47.08
Ophthalmological exam, comprehensive, established patient
$84K
8K claims · 0.0%
$71K
386 claims · 0.0%
Group psychotherapy
$50K
19K claims · 0.0%
$49K
2K claims
$30.97
$27.28
Comprehensive audiometry, air, bone, and speech testing
$49K
2K claims · 0.0%
$46K
42K claims
$1.08
$3.67
Brief emotional/behavioral assessment, per standardized instrument
$46K
42K claims · 0.0%
$44K
306 claims
$143.08
$8.79
Brief communication technology-based service
$44K
306 claims · 0.0%
$30K
5K claims
$5.68
$74.09
Office/outpatient visit, high complexity
$30K
5K claims · 0.0%
$26K
4K claims · 0.0%
$22K
4K claims · 0.0%
$21K
329 claims
$65.14
$73.29
Medication-assisted treatment, opioid use disorder, per month
$21K
329 claims · 0.0%
$21K
2K claims
$9.56
$38.23
Ophthalmological exam, intermediate, established patient
$21K
2K claims · 0.0%
$20K
2K claims
$10.45
$13.30
Telephone E/M by physician, 5-10 min
$20K
2K claims · 0.0%
$19K
27K claims
$0.71
$9.80
Immunization administration, 1 vaccine, percutaneous/ID/SC/IM
$19K
27K claims · 0.0%
Other Top Providers in Connecticut
View all →Similar Providers
Other top providers in Psychiatry & Neurology, Child & Adolescent Psychiatry