KIMBERLY R WILSON, LCSW
NPI 1255639431, individual, Bowling Green, KY, Social Worker, Clinical
- Hours beyond a day in 3 months under one organization, which can be supervisory billing.
- 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 2020 | More hours than a day holds, even counting one unit per claim line | 24.6 | 16.6 | 11.0 | 16.3 | 364 | 2 | 90791 90832 90834 90837 | $37K |
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 24.8 | 18.6 | 12.4 | 17.4 | 389 | 2 | 90791 90832 90834 90837 90853 | $38K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 24.6 | 22.1 | 14.7 | 19.9 | 463 | 2 | 90791 90832 90834 90837 90853 | $52K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | KIMBERLY R WILSON, LCSW |
| Type | Individual |
| Status | Active |
| NPI issued | March 11, 2011, last updated July 9, 2026 |
| Practice location | 1815 DESTINY LN STE C, Bowling Green, KY 42104-1074, 270-904-1072 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license KY 3505 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.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $2.3M | 57% | $129 | $191 (top 5% from $442) | 22nd percentile | |
| T2023 | Medicaid service code | $1.1M | 27% | $334 | $332 (top 5% from $1K) | 53rd percentile | |
| 90834 | Psychotherapy, 45 minutes | $233K | 6% | $63 | $101 (top 5% from $318) | 25th percentile | |
| H0032 | Medicaid service code | $156K | 4% | $62 | $98 (top 5% from $675) | 23rd percentile | |
| 90832 | Psychotherapy, 30 minutes | $112K | 3% | $50 | $59 (top 5% from $239) | 40th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $86K | 2% | $74 | $105 (top 5% from $228) | 28th percentile | |
| 99354 | Prolonged service outpatient first hour (retired 2023) | $38K | 1% | $66 | $78 (top 5% from $222) | 40th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $23K | 1% | $27 | $60 (top 5% from $332) | 21st percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 217 | 22 | $16K | $150 | $100 | 1.5x | 1.6x (90th percentile 2.9x) |
| 90791 | Psychiatric diagnostic evaluation | 12 | 12 | $1K | $175 | $122 | 1.4x | 1.9x (90th percentile 3.6x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
6 providers in Warren County, KY carry an indicator in the public record, with $8.2M at stake between them. The most common is more hours than a day holds, on 3 of them, followed by paid after a public list action on 2. 3 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | THOMAS HUGHES Bowling Green, KY, ranked 121 | $152K |
|
| 1 | ACCULAB, LLC Bowling Green, KY, ranked 278 | $12K |
|
| 1 | ZIA NEUROLOGY ASSOCIATES, LLC Bowling Green, KY, ranked 299 | $8K |
|
| 4 | MICHELLE CONNER Bowling Green, KY, ranked 8479 | $3.7M |
|
| 4 | KRISTINA FULLER Bowling Green, KY, ranked 8632 | $2.5M |
|
| 5 | EMILY EDWARDS Bowling Green, KY, ranked 10829 | $1.9M |
Recent enforcement in KY
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.