Clinical Resource Management, LLC

Clinical Resource Management, LLC was paid $1.61M by Medicaid between Aug 2023 and Oct 2024, across 2 billing codes. Its largest line is H0037, Community psychiatric supportive treatment program, per diem — 95% of everything it billed.

33Billing provider infoCLINICAL RESOURCE MANAGEMENT, LLC
ROCHESTER, PA 15074

33aNPI1295357697assigned 05/08/2020

33bProvider typeMental Illness Community Based Residential Treatment Facility

28Total paid$1.61M

24GClaims729

24DCodes billed2

24AFirst – last monthAug 2023 – Oct 2024

Compared with peers

Next to other Mental Illness Community Based Residential Treatment Facility providers in Pennsylvania

Rank by total paid#8 of 13

Median peer was paid$1.73M

This provider vs. median0.9×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration95% of spending on code H0037 with only 2 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2023	419	$719K
2024incomplete	310	$894K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0037	Community psychiatric supportive treatment program, per diem	95%	525	179	$1.54M
T2048	Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem	4.8%	204	70	$77K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialWEST, ANDRE (OWNER/CEO)