STANDARDS-BASED SOLUTIONS BEHAVIORAL HEALTH CONSULTING
NPI: 1932540465
· CHAPEL HILL, NC 27514
· Mental Health Counselor
· NPI assigned 07/12/2013
Billing Flags
· Automated signals — not evidence of fraud
Single-Code Concentration
90% of spending on code H0038 with only 2 total codes billed. Highly concentrated billing profile.
$8.36M
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
14,826 |
$1.89M |
| 2019 |
12,193 |
$1.66M |
| 2020 |
10,487 |
$1.13M |
| 2021 |
7,467 |
$639K |
| 2022 |
9,189 |
$937K |
| 2023 |
10,293 |
$1.21M |
| 2024 |
7,645 |
$892K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0038 |
Self-help/peer services, per 15 minutes |
66,485 |
6,464 |
$7.52M |
| T1019 |
Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) |
5,615 |
417 |
$832K |