CRYSTAL M CRUMLEY, M.S.
NPI 1235352360, individual, Cleveland, TN, Counselor, Mental Health
- Hours beyond a day in 27 months, but with up to 1248 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
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.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 32.8 | 62.4 | 41.6 | 56.1 | 398 | 1 | 90791 90832 90834 90837 | $120K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 48.3 | 91.7 | 61.1 | 83.4 | 543 | 1 | 90791 90832 90834 90837 | $171K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 49.2 | 93.3 | 62.2 | 91.8 | 776 | 1 | 90791 90832 90834 90837 90847 90853 | $182K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 65.9 | 125.3 | 83.5 | 113.9 | 895 | 1 | 90791 90832 90834 90837 90847 | $235K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 51.8 | 99.3 | 66.2 | 93.3 | 843 | 1 | 90791 90832 90834 90837 90847 | $193K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 62.1 | 115.8 | 77.2 | 108.8 | 1029 | 1 | 90791 90832 90834 90837 90847 | $229K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 62.1 | 118.9 | 79.3 | 111.0 | 1080 | 1 | 90791 90832 90834 90837 90846 90847 | $213K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 44.4 | 86.1 | 57.4 | 77.3 | 1244 | 1 | 90791 90832 90834 90837 90846 90847 90853 | $171K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 42.1 | 81.9 | 54.6 | 81.9 | 1217 | 1 | 90791 90832 90834 90837 90846 90847 | $158K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 45.6 | 84.6 | 56.4 | 76.0 | 1248 | 1 | 90791 90832 90834 90837 90846 90847 | $168K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 29.7 | 58.0 | 38.6 | 52.7 | 793 | 1 | 90791 90832 90834 90837 90847 | $111K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 40.6 | 81.8 | 54.5 | 80.5 | 647 | 1 | 90791 90832 90834 90837 90847 | $163K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 86.7 | 173.4 | 115.6 | 155.8 | 1185 | 1 | 90791 90832 90834 90837 90846 90847 | $343K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 94.3 | 189.7 | 126.4 | 180.6 | 1201 | 1 | 90791 90832 90834 90837 90846 90847 | $363K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 82.5 | 165.7 | 110.5 | 155.7 | 1120 | 1 | 90791 90832 90834 90837 90846 90847 | $327K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 85.6 | 169.9 | 113.3 | 154.5 | 1113 | 1 | 90791 90832 90834 90837 90846 90847 | $324K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 57.9 | 116.4 | 77.6 | 114.5 | 917 | 1 | 90791 90832 90834 90837 90846 90847 | $230K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 67.1 | 126.4 | 84.3 | 113.6 | 973 | 1 | 90791 90832 90834 90837 90846 90847 | $265K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 73.7 | 140.4 | 93.6 | 129.2 | 1020 | 1 | 90791 90832 90834 90837 90846 90847 | $275K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 36.2 | 70.7 | 47.2 | 69.6 | 964 | 1 | 90791 90832 90834 90837 90846 90847 | $148K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 40.5 | 79.2 | 52.8 | 72.0 | 968 | 1 | 90791 90832 90834 90837 90846 90847 | $160K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 31.6 | 62.3 | 41.6 | 56.0 | 913 | 1 | 90791 90832 90834 90837 90846 90847 | $131K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 35.7 | 70.3 | 46.9 | 66.1 | 964 | 1 | 90791 90832 90834 90837 90846 90847 | $148K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 42.1 | 81.4 | 54.3 | 77.5 | 995 | 1 | 90791 90832 90834 90837 90846 90847 | $167K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 56.8 | 85.8 | 57.2 | 77.1 | 1075 | 1 | 90791 90832 90834 90837 90846 90847 | $181K |
| Nov 2024 | More hours than a day holds, even counting one unit per claim line | 39.9 | 74.2 | 49.5 | 70.6 | 987 | 1 | 90791 90832 90834 90837 90846 90847 | $151K |
| Dec 2024 | More hours than a day holds, even counting one unit per claim line | 30.9 | 58.7 | 39.1 | 55.1 | 846 | 1 | 90791 90832 90834 90837 90846 90847 | $123K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CRYSTAL M CRUMLEY, M.S. (also CRYSTAL SHIRE) |
| Type | Individual |
| Status | Active |
| NPI issued | April 10, 2007, last updated January 22, 2024 |
| Practice location | 4160 OCOEE ST N STE 8, Cleveland, TN 37312-4886, 888-291-4357 |
| Specialties | Counselor, Mental Health (101YM0800X, primary) |
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.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $2.4M | 35% | $279 | $191 (top 5% from $442) | 80th percentile | |
| 90834 | Psychotherapy, 45 minutes | $2.2M | 33% | $188 | $101 (top 5% from $318) | 82nd percentile | |
| 90832 | Psychotherapy, 30 minutes | $1.6M | 24% | $137 | $59 (top 5% from $239) | 88th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $385K | 6% | $189 | $105 (top 5% from $228) | 91st percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $123K | 2% | $137 | $130 (top 5% from $458) | 53rd percentile | |
| 90846 | Family psychotherapy without patient, 50 minutes | $51K | 1% | $89 | $113 (top 5% from $277) | 29th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $9K | 0% | $61 | $60 (top 5% from $332) | 51st percentile |
In this area
6 providers in Bradley County, TN carry an indicator in the public record, with $9.8M at stake between them. The most common is more hours than a day holds, on 6 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | DAVID FRANZ Cleveland, TN, ranked 8487 | $3.6M |
|
| 4 | JAMES LEWICKI Cleveland, TN, ranked 8594 | $2.8M |
|
| 4 | CHRISTIAN HUGHES Cleveland, TN, ranked 8753 | $1.9M |
|
| 4 | REBA TERRY Cleveland, TN, ranked 8940 | $1.2M |
|
| 4 | DAVID WEBB Cleveland, TN, ranked 9400 | $262K |
|
| 5 | MEGAN GODBEE Cleveland, TN, ranked 11638 | $94K |
Recent enforcement in TN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.