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 |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $1.4B | 9.8M |
| H0036 | Comm psy face-face per 15min | $796.1M | 9.1M |
| T2016 | Habil res waiver per diem | $559.0M | 977.1K |
| T1015 | Clinic service | $188.1M | 1.7M |
| H0039 | Asser com tx face-face/15min | $155.9M | 1.4M |
| A0429 | Bls-emergency | $136.2M | 235.2K |
| 99283 | Emergency dept visit low mdm | $124.3M | 815.2K |
| 99284 | Emergency dept visit mod mdm | $117.3M | 830.5K |
| 99213 | Office o/p est low 20 min | $99.1M | 2.0M |
| 99214 | Office o/p est mod 30 min | $98.9M | 1.3M |