CMS T-MSIS data, 2018-2024
Concourse Sentinel connects to large-scale healthcare billing datasets β including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists β and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| S5125 | Attendant care service /15m | $3.5B | 28.1M |
| T1015 | Clinic service | $2.8B | 11.8M |
| T2016 | Habil res waiver per diem | $1.4B | 4.5M |
| T1016 | Case management | $1.4B | 40.1M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | $1.2B | 13.7M |
| 99214 | Office o/p est mod 30 min | $1.1B | 19.5M |
| 99285 | Emergency dept visit hi mdm | $904.2M | 3.8M |
| 99284 | Emergency dept visit mod mdm | $874.1M | 4.7M |
| H0018 | Behavioral health; short-term residential (non-hospital residential treatment | $817.6M | 2.5M |
| 99213 | Office o/p est low 20 min | $742.0M | 16.1M |