Providers

CURTIS L NELSON, L.C.S.W.

NPI 1194932939, individual, Louisville, KY, Social Worker, Clinical

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 21 months, but with up to 524 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 52 of 100, rank 8353, $6.6M at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Sep 2020More hours than a day holds, even counting one unit per claim line29.346.030.623.1376190837 99354 99355 H2015$113K
Oct 2020More hours than a day holds, even counting one unit per claim line41.540.627.122.5396190837 99354 99355 H2015$103K
Mar 2021More hours than a day holds, even counting one unit per claim line28.931.821.219.6381190837 99354 99355 H2015$93K
Apr 2021More hours than a day holds, even counting one unit per claim line29.231.821.219.3427190791 90832 90834 90837 99354 99355 H2015$91K
Sep 2021More hours than a day holds, even counting one unit per claim line29.734.923.321.7433190791 90837 99354 99355 H2015$99K
Oct 2021More hours than a day holds, even counting one unit per claim line30.336.824.525.8469190791 90837 99354 99355 H2015$105K
Nov 2021More hours than a day holds, even counting one unit per claim line29.337.424.924.0459190791 90837 99354 99355 H2015$104K
Dec 2021More hours than a day holds, even counting one unit per claim line36.546.931.330.0524190791 90837 99354 99355 H2015$134K
Jan 2022More hours than a day holds, even counting one unit per claim line29.541.827.924.9494190791 90832 90837 99354 99355 H2015$116K
Mar 2022More hours than a day holds, even counting one unit per claim line30.945.230.123.2471190791 90832 90837 99354 99355 H2015$125K
Apr 2022More hours than a day holds, even counting one unit per claim line31.644.629.725.7474190791 90837 99354 99355 H2015$118K
May 2022More hours than a day holds, even counting one unit per claim line34.142.628.423.4518190791 90837 99354 99355 H2015$117K
Jun 2022More hours than a day holds, even counting one unit per claim line32.041.227.423.2477190837 99354 99355 H2015$110K
Aug 2022More hours than a day holds, even counting one unit per claim line27.236.724.520.5411190791 90837 99354 99355 H2015$101K
Sep 2022More hours than a day holds, even counting one unit per claim line28.936.124.121.8415190791 90837 99354 99355 H2015$94K
Nov 2022More hours than a day holds, even counting one unit per claim line28.137.224.822.9429190791 90837 99354 99355 H2015$96K
Dec 2022More hours than a day holds, even counting one unit per claim line27.236.124.122.8411190791 90837 99354 99355 H2015$97K
May 2023More hours than a day holds, even counting one unit per claim line33.838.325.621.8494190791 90832 90837 H0004 H2015$119K
Jun 2023More hours than a day holds, even counting one unit per claim line33.536.224.219.5401190837 H0004 H2015$116K
Feb 2024More hours than a day holds, even counting one unit per claim line25.930.820.520.1356190791 90832 90837 H0004 H2015$78K
Mar 2024More hours than a day holds, even counting one unit per claim line28.233.322.221.3431190791 90832 90837 H0004 H2015$91K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameCURTIS L NELSON, L.C.S.W.
TypeIndividual
StatusActive
NPI issuedMay 17, 2007, last updated October 31, 2023
Practice location4400 BRECKENRIDGE LN STE 125, Louisville, KY 40218-4135, 502-472-4232
Mailing addressPO BOX 2587, Louisville, KY 40201-2587
Specialties
Social Worker, Clinical (1041C0700X, primary, license 3558 KY)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes
codewhat it ispaidshareper patient-monthtypicalrank among providers
H2015Comprehensive community support services per 15 minhistory of abuse$2.8M30%$449$344 (top 5% from $2K)57th percentile
90837Psychotherapy, 1 hourhistory of abuse$2.1M22%$219$191 (top 5% from $442)61st percentile
T2023Medicaid service code$1.7M19%$338$332 (top 5% from $1K)56th percentile
99354Prolonged service outpatient first hour (retired 2023)$764K8%$149$78 (top 5% from $222)84th percentile
H2021Community-based wrap-around services per 15 min$622K7%$451$845 (top 5% from $4K)38th percentile
90887Medicaid service code$557K6%$112$98 (top 5% from $270)58th percentile
99355Prolonged service outpatient each addl 30 min (retired 2023)$284K3%$109$111 (top 5% from $377)49th percentile
H0004Behavioral health counseling and therapy per 15 minhistory of abuse$280K3%$140$174 (top 5% from $559)40th percentile

In this area

59 providers in Jefferson County, KY carry an indicator in the public record, with $94.6M at stake between them. The most common is more hours than a day holds, on 45 of them, followed by paid after a public list action on 6. 4 are tier 1: documented action, then payment.

tierproviderat stakewhy
1MAJA CUPAC
Louisville, KY, ranked 65
$9K
  • Listed on the KY Medicaid exclusion list since April 22, 2022.
  • Medicaid still paid claims in 4 later months, $8,911 in total.
  • and 1 more
1BAKER CHIROPRACTIC CENTER PSC
Louisville, KY, ranked 139
$119K
  • Listed on the KY Medicaid exclusion list and the Medicare revocation list since January 4, 2024.
  • Medicaid still paid claims in 10 later months, $119,249 in total.
1MICHAEL BAKER
Louisville, KY, ranked 140
$119K
  • Listed on the Medicare revocation list and the KY Medicaid exclusion list since January 4, 2024.
  • Medicaid still paid claims in 10 later months, $119,249 in total.
1JORDAN EDELEN
Louisville, KY, ranked 261
$14K
  • Listed on the KY Medicaid exclusion list and the Medicare revocation list since December 16, 2019.
  • Medicaid still paid claims in 9 later months, $14,032 in total.
3CHRISTIAN BERKHAHN
Louisville, KY, ranked 1301
$161K
  • Charged (charged) per a Department of Justice release dated June 23, 2026, not adjudicated.
  • Medicaid paid $161,424 in the last 12 observed months.
3LAWRENCE PETERS
Louisville, KY, ranked 1509
$16K
  • Charged (charged) per a Department of Justice release dated June 27, 2024, not adjudicated.
  • Medicaid paid $16,372 in the last 12 observed months.
3MATTHEW ELKINS
Louisville, KY, ranked 1571
$7K
  • Charged (charged) per a Department of Justice release dated July 1, 2025, not adjudicated.
  • Medicaid paid $6,952 in the last 12 observed months.
3LOUISVILLE KY OPCO LLC
Louisville, KY, ranked 1885
$0
  • Part of provider network D1-00087, ranked 87 nationally.
All 59 in KY

Recent enforcement in KY

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJIndictedAug 27, 2026
Kentucky Medical Biller Indicted for Healthcare Fraud and Money Laundering Charges
Sanders recruited individuals to open behavioral health entities, handled their Kentucky Medicaid credentialing and enrollment, and directed submission of fraudulent Medicaid claims across ten behavioral health providers for services never provided, including for incarcerated, hospitalized, or deceased members, using licensed professionals' NPIs without authorization.
DOJChargedJun 23, 2026
5 Individuals and 2 Companies Charged as Part of Department of Justice National Health Care Fraud Takedown
Seven defendants were charged in four cases with schemes including billing Kentucky Medicaid for peer support and psychoeducation services that were fraudulent, unauthorized, or not rendered using providers' NPIs, using a DEA number to order controlled substances in others' names, credentialing a company with Medicare and billing for services not rendered using a doctor's NPI, and stealing controlled substances from hospitals and falsely documenting administration.
DOJCivil settlementJun 23, 2026
Civil Settlements Reached as Part of Department of Justice National Health Care Fraud Takedown
Three Home and Community Based Waiver providers and their owners, who had shared financial interests, referred Medicaid waiver beneficiaries for attendant care services and billed Medicaid for attendant care hours that were not fully provided or not provided at all.
DOJCivil judgmentMay 15, 2026
Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations
The Government alleged that from August 2022 through June 2025 the Recovery Centers sought Medicaid payments for time children spent on education, recreation, and lunch breaks at the Aspire Day Program and that Recovery Center of Kentucky falsely represented clinician qualifications to obtain higher reimbursements.
DOJSentencedApr 24, 2026
Former Sober Home Owner and Operator Sentenced for Kickback Conspiracy and Health Care Fraud
Jordan solicited and received kickbacks in exchange for referring urine drug testing from her sober home company to three labs, and Serenity Keepers billed Medicaid for peer support services not provided by licensed peer support specialists, with Williams reporting that residents received six hours of peer support services per day knowing that was not true.

Referral packet

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