T-MSIS provider-level spending data, Jan 2018 – Dec 2024
Total Outliers
5,000
Providers billing >2x or <0.5x procedure median
Above 2x Median
2,360
Providers charging significantly above median
Below 0.5x Median
2,581
Providers charging significantly below median
Each dot is a provider-procedure pair. Red = above 2x median. Blue = below 0.5x median.
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| # | Provider | State | Procedure | $/Claim | Proc. Median | Cost Index?Provider's cost per claim divided by the procedure median. 1.0x = at median, 2.0x = twice the median.▼ | Total Paid | Claims |
|---|---|---|---|---|---|---|---|---|
| 1 | 1275651267 SPECIALIZED COMMUNITY CARE, INC | VT | 99199 Unlisted special service, procedure, or report | $10,636 | $7 | 1599.32x | $40.5M | 3,811 |
| 2 | 1649838533 GREEN MOUNTAIN SUPPORT SERVICES INC. | VT | 99199 Unlisted special service, procedure, or report | $7,925 | $7 | 1191.75x | $25.9M | 3,272 |
| 3 | 1538292768 NORTHEAST KINGDOM HUMAN SERVICES INC DS WAIVER | VT | 99199 Unlisted special service, procedure, or report | $7,409 | $7 | 1114.21x | $144.1M | 19,452 |
| 4 | 1144347824 LAMOILLE COUNTY HEALTH MENTAL HEALTH SERVICES | VT | 99199 Unlisted special service, procedure, or report | $6,954 | $7 | 1045.78x | $33.6M | 4,834 |
| 5 | 1376760835 HEALTH CARE & REHABILITATION SERVICES | VT | 99199 Unlisted special service, procedure, or report | $6,462 | $7 | 971.70x | $97.6M | 15,101 |
| 6 | 1710901939 WASHINGTON COUNTY MENTAL HEALTH SERVICES, INC. | VT | 99199 Unlisted special service, procedure, or report | $6,288 | $7 | 945.63x | $101.7M | 16,175 |
| 7 | 1780708263 NORTHWESTERN COUNSELING & SUPPORT SERVICES | VT | 99199 Unlisted special service, procedure, or report | $6,259 | $7 | 941.24x | $90.9M | 14,520 |
| 8 | 1235261009 RUTLAND MENTAL HEALTH SERVICES | VT | 99199 Unlisted special service, procedure, or report | $5,863 | $7 | 881.63x | $83.1M | 14,169 |
| 9 | 1770700221 HOWARD CENTER INC | VT | 99199 Unlisted special service, procedure, or report | $5,705 | $7 | 857.83x | $224.8M | 39,413 |
| 10 | 1730218868 COUNSELING SERVICE OF ADDISON COUNTY | VT | 99199 Unlisted special service, procedure, or report | $5,458 | $7 | 820.72x | $45.3M | 8,309 |
| 11 | 1366579112 UNITED COUNSELING SERVICE OF BENNINGTON COUNTY, INC. | VT | 99199 Unlisted special service, procedure, or report | $5,186 | $7 | 779.92x | $50.3M | 9,696 |
| 12 | 1508990490 SOMERVILLE CAMBRIDGE ELDER SERVICES | MA | G0156 Hhcp-svs of aide,ea 15 min | $4,375 | $46 | 94.70x | $36.5M | 8,335 |
| 13 | 1508907338 OPEN DOORS FOR THE DEVELOPMENTALLY CHALLENGED, INC. | WV | S5125 Attendant care service /15m | $5,539 | $64 | 86.83x | $22.1M | 3,994 |
| 14 | 1861568107 MELMARK, INC. | PA | H0019 Alcohol and/or drug services | $29,034 | $360 | 80.76x | $35.0M | 1,204 |
| 15 | 1578683694 MYSTIC VALLEY ELDER SERVICES, INC. | MA | G0156 Hhcp-svs of aide,ea 15 min | $3,578 | $46 | 77.45x | $84.1M | 23,503 |
| 16 | 1891907788 UNITED SUMMIT CENTER INC-WAVIER | WV | S5125 Attendant care service /15m | $4,474 | $64 | 70.14x | $21.4M | 4,775 |
| 17 | 1699896316 REM COMMUNITY OPTIONS, INC. | WV | S5125 Attendant care service /15m | $3,739 | $64 | 58.61x | $188.4M | 50,383 |
| 18 | 1184780629 VOCA CORPORATION OF WEST VIRGINIA, INC. | WV | S5125 Attendant care service /15m | $3,655 | $64 | 57.30x | $160.0M | 43,776 |
| 19 | 1184758310 SPRINGWELL | MA | G0156 Hhcp-svs of aide,ea 15 min | $2,488 | $46 | 53.86x | $43.3M | 17,386 |
| 20 | 1255496220 RSCR WEST VIRGINIA, INC. | WV | S5125 Attendant care service /15m | $3,362 | $64 | 52.71x | $144.1M | 42,855 |
| 21 | 1780711291 AUTISM SERVICE CENTER | WV | S5125 Attendant care service /15m | $2,890 | $64 | 45.30x | $47.6M | 16,460 |
| 22 | 1518953652 SENECA HEALTH SERVICES INC | WV | S5125 Attendant care service /15m | $2,789 | $64 | 43.72x | $28.8M | 10,309 |
| 23 | 1477955235 PSYCHOLOGICAL ASSESSMENT & INTERVENTION SERVICES, LLC | WV | S5125 Attendant care service /15m | $2,697 | $64 | 42.28x | $41.1M | 15,244 |
| 24 | 1750696852 COMMUNITY NEUROREHAB OF IOWA | IA | H0019 Alcohol and/or drug services | $14,336 | $360 | 39.87x | $28.0M | 1,953 |
| 25 | 1578683694 MYSTIC VALLEY ELDER SERVICES, INC. | MA | S5125 Attendant care service /15m | $2,524 | $64 | 39.56x | $21.2M | 8,392 |
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