Specialized Health Management INC
Specialized Health Management INC was paid $85K by Medicaid between Jan 2018 and Sep 2023, across 13 billing codes. Its largest line is 99309, Subsequent nursing facility care, per day, low to moderate complexity — 48% of everything it billed.
33Billing provider infoSPECIALIZED HEALTH MANAGEMENT INC
NEEDHAM, MA 02494
NEEDHAM, MA 02494
33aNPI1700912656assigned 02/26/2007
33bProvider typeAdult Psychiatric/Mental Health Registered Nurse
28Total paid$85K
24GClaims7,046
24DCodes billed13
24AFirst – last monthJan 2018 – Sep 2023
Compared with peers
Next to other Adult Psychiatric/Mental Health Registered Nurse providers in Massachusetts
Rank by total paid#6 of 14
Median peer was paid$63K
This provider vs. median1.3×
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.
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 | |
|---|---|---|---|
| 2018 | 1,700 | $23K | |
| 2019 | 2,548 | $36K | |
| 2020 | 1,496 | $13K | |
| 2021 | 693 | $2K | |
| 2022 | 343 | $3K | |
| 2023 | 266 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 48% | 5,660 | 2,920 | $41K |
| 99205 | Prolong outpt/office vis | 29% | 176 | 176 | $24K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 6.8% | 526 | 360 | $6K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 5.8% | 77 | 56 | $5K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 2.8% | 160 | 58 | $2K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.4% | 42 | 37 | $2K |
| 99336 | 2.2% | 88 | 53 | $2K | |
| 99448 | 2.2% | 140 | 75 | $2K | |
| 99349 | <1% | 16 | 13 | $252.21 | |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 52 | 13 | $194.69 |
| 99306 | Prolong nursin fac eval 15m | <1% | 16 | 12 | $117.00 |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 68 | 36 | $96.09 |
1 more codes
| 99443 | <1% | 25 | $29.75 |
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 officialNAGER, NANCY (PRESIDENT AND CEO)