Providers
DANIEL L KINSEY, M.D.
NPI 1306880109, individual, Goshen, IN, Psychiatry & Neurology, Child & Adolescent Psychiatry
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 83 months, but with up to 7636 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 53 of 100, rank 8200, $85.0M 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.
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds, even counting one unit per claim line | 249.3 | 341.9 | 227.9 | 236.6 | 5507 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H2014 T1016 | $888K |
| Feb 2018 | More hours than a day holds, even counting one unit per claim line | 221.8 | 298.5 | 199.0 | 209.5 | 4763 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $715K |
| Mar 2018 | More hours than a day holds, even counting one unit per claim line | 240.3 | 328.7 | 219.1 | 231.4 | 5397 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H2014 T1016 | $873K |
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 218.7 | 264.5 | 176.3 | 181.2 | 5218 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H2014 T1016 | $704K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 225.6 | 282.0 | 188.0 | 179.3 | 5467 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $788K |
| Jun 2018 | More hours than a day holds, even counting one unit per claim line | 201.6 | 249.8 | 166.5 | 164.6 | 4959 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $686K |
| Jul 2018 | More hours than a day holds, even counting one unit per claim line | 187.6 | 239.5 | 159.6 | 150.2 | 5104 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $705K |
| Aug 2018 | More hours than a day holds, even counting one unit per claim line | 210.0 | 298.8 | 199.2 | 186.0 | 5443 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $845K |
| Sep 2018 | More hours than a day holds, even counting one unit per claim line | 190.1 | 276.3 | 184.2 | 194.8 | 5061 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $753K |
| Oct 2018 | More hours than a day holds, even counting one unit per claim line | 233.9 | 339.3 | 226.2 | 217.6 | 5917 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H2014 T1016 | $940K |
| Nov 2018 | More hours than a day holds, even counting one unit per claim line | 217.2 | 328.0 | 218.7 | 211.9 | 5540 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $877K |
| Dec 2018 | More hours than a day holds, even counting one unit per claim line | 193.3 | 325.5 | 217.0 | 238.5 | 5463 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $860K |
| Jan 2019 | More hours than a day holds, even counting one unit per claim line | 253.8 | 393.1 | 262.1 | 263.2 | 6029 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $1.1M |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 293.1 | 453.0 | 302.0 | 323.1 | 6384 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $1.1M |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 261.8 | 398.3 | 265.6 | 298.8 | 6593 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H2014 T1016 | $1.1M |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 289.6 | 449.7 | 299.8 | 314.5 | 6931 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H2014 T1016 | $1.2M |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 268.9 | 427.9 | 285.3 | 294.0 | 6762 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H2014 T1016 | $1.2M |
| Jun 2019 | More hours than a day holds, even counting one unit per claim line | 244.2 | 387.6 | 258.4 | 292.7 | 6231 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H2014 T1016 | $1.0M |
| Jul 2019 | More hours than a day holds, even counting one unit per claim line | 253.5 | 404.3 | 269.5 | 275.4 | 6497 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0038 H2014 T1016 | $1.1M |
| Aug 2019 | More hours than a day holds, even counting one unit per claim line | 241.7 | 383.5 | 255.7 | 267.2 | 6467 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $1.1M |
| Sep 2019 | More hours than a day holds, even counting one unit per claim line | 239.7 | 376.6 | 251.1 | 267.1 | 6333 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H0038 H2014 T1016 | $1.0M |
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 271.6 | 426.3 | 284.2 | 286.8 | 6974 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H0034 H0038 H2014 T1016 | $1.2M |
| Nov 2019 | More hours than a day holds, even counting one unit per claim line | 231.7 | 373.3 | 248.9 | 264.3 | 6358 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0004 H0034 H0038 H2014 T1016 | $1.0M |
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 213.9 | 342.9 | 228.6 | 244.5 | 6110 | 4 | 90791 90792 90832 90834 90837 90839 90846 90847 90853 99211 99213 99214 H0004 H2014 T1016 | $966K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 257.9 | 390.9 | 260.6 | 266.2 | 6841 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0004 H0034 H2014 T1016 | $1.1M |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 249.6 | 382.4 | 254.9 | 276.8 | 6431 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0004 H2014 T1016 | $1.0M |
| Mar 2020 | More hours than a day holds, even counting one unit per claim line | 241.6 | 361.3 | 240.9 | 257.3 | 6830 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H2014 T1016 | $1.1M |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 261.0 | 399.9 | 266.6 | 287.3 | 6881 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H2014 T1016 | $1.1M |
| May 2020 | More hours than a day holds, even counting one unit per claim line | 234.3 | 365.6 | 243.7 | 285.4 | 6407 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0004 H0038 H2014 T1016 | $1.0M |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 267.8 | 413.3 | 275.6 | 296.0 | 7013 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H0038 H2014 T1016 | $1.1M |
| Jul 2020 | More hours than a day holds, even counting one unit per claim line | 257.5 | 403.0 | 268.6 | 282.6 | 6810 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H2014 T1016 | $1.2M |
| Aug 2020 | More hours than a day holds, even counting one unit per claim line | 252.0 | 442.2 | 294.8 | 347.0 | 6936 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H0038 H2014 T1016 | $1.2M |
| Sep 2020 | More hours than a day holds, even counting one unit per claim line | 280.9 | 497.3 | 331.6 | 368.4 | 6959 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $1.3M |
| Oct 2020 | More hours than a day holds, even counting one unit per claim line | 274.0 | 485.0 | 323.3 | 367.9 | 7431 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H0034 H0038 H2014 T1016 | $1.4M |
| Nov 2020 | More hours than a day holds, even counting one unit per claim line | 255.0 | 455.6 | 303.8 | 354.1 | 7030 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0004 H0034 H0038 H2014 T1016 | $1.2M |
| Dec 2020 | More hours than a day holds, even counting one unit per claim line | 265.9 | 469.1 | 312.7 | 350.8 | 7317 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0004 H0038 H2014 T1016 | $1.3M |
| Jan 2021 | More hours than a day holds, even counting one unit per claim line | 282.0 | 475.4 | 316.9 | 391.8 | 7292 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H0038 H2014 T1016 | $1.3M |
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 292.5 | 496.3 | 330.9 | 383.8 | 7384 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0004 H0038 H2014 T1016 | $1.3M |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 299.6 | 506.1 | 337.4 | 376.0 | 7636 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0004 H0034 H0038 H2014 T1016 | $1.4M |
| Apr 2021 | More hours than a day holds, even counting one unit per claim line | 271.5 | 460.3 | 306.9 | 342.5 | 6959 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $1.3M |
| May 2021 | More hours than a day holds, even counting one unit per claim line | 235.9 | 400.1 | 266.7 | 323.7 | 6741 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0038 H2014 T1016 | $1.1M |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 257.0 | 431.3 | 287.5 | 324.7 | 6860 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $1.2M |
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 214.2 | 366.8 | 244.5 | 280.5 | 6074 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $1.1M |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 240.1 | 402.3 | 268.2 | 306.3 | 6284 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $1.2M |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 249.2 | 415.0 | 276.7 | 306.5 | 6249 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $1.2M |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 234.8 | 398.2 | 265.4 | 316.1 | 6205 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $1.2M |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 249.7 | 418.3 | 278.9 | 310.2 | 6455 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $1.2M |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 234.6 | 397.8 | 265.2 | 292.0 | 6325 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $1.1M |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 220.2 | 395.3 | 263.5 | 323.0 | 6419 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H2014 T1016 | $1.1M |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 250.8 | 428.5 | 285.7 | 333.7 | 6149 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $1.1M |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 277.9 | 469.4 | 312.9 | 354.7 | 6843 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H2014 T1016 | $1.3M |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 240.6 | 404.9 | 269.9 | 324.7 | 6212 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H2014 T1016 | $1.1M |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 237.9 | 401.5 | 267.7 | 321.0 | 6307 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $1.1M |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 246.9 | 417.3 | 278.2 | 320.2 | 6035 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $1.1M |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 194.3 | 330.6 | 220.4 | 276.3 | 5515 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $928K |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 219.3 | 401.5 | 267.7 | 310.5 | 5761 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $1.1M |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 194.7 | 369.9 | 246.6 | 287.5 | 5400 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $981K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 196.6 | 381.4 | 254.2 | 322.9 | 5492 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $1.0M |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 210.7 | 408.4 | 272.3 | 324.6 | 5727 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $1.1M |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 183.4 | 351.5 | 234.3 | 287.7 | 5319 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H2014 T1016 | $958K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 212.5 | 399.1 | 266.1 | 328.2 | 5785 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $1.1M |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 215.2 | 409.2 | 272.8 | 331.6 | 5536 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $992K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 225.4 | 435.4 | 290.2 | 340.5 | 6085 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $1.2M |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 194.8 | 377.7 | 251.8 | 325.0 | 5630 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $976K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 208.6 | 403.5 | 269.0 | 315.4 | 5765 | 4 | 90791 90792 90832 90834 90837 90839 90846 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $1.1M |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 201.7 | 392.9 | 261.9 | 309.4 | 5570 | 4 | 90791 90792 90832 90834 90837 90847 90853 99211 99212 99213 99214 H0034 H0038 H2014 T1016 | $1.0M |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 165.4 | 326.5 | 217.7 | 276.8 | 5151 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H2014 T1016 | $885K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 198.7 | 384.2 | 256.2 | 300.1 | 5582 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $1.0M |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 179.1 | 341.7 | 227.8 | 276.5 | 5018 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $899K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 185.4 | 357.6 | 238.4 | 284.4 | 5389 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $971K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 192.6 | 350.5 | 233.7 | 270.3 | 5118 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $922K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 171.1 | 306.8 | 204.5 | 253.9 | 4756 | 4 | 90791 90792 90832 90834 90837 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $840K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 173.8 | 341.0 | 227.4 | 239.3 | 4925 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $998K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 171.8 | 340.2 | 226.8 | 235.8 | 4818 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $924K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 158.9 | 311.6 | 207.7 | 233.9 | 4775 | 4 | 90791 90792 90832 90834 90837 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $901K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 128.5 | 249.3 | 166.2 | 226.6 | 3833 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 | $656K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 126.9 | 244.3 | 162.9 | 219.5 | 3812 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 | $656K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 122.6 | 226.5 | 151.0 | 226.0 | 3757 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $586K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 134.4 | 247.6 | 165.1 | 221.4 | 4063 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H2014 T1016 | $670K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 135.6 | 252.4 | 168.2 | 234.0 | 4067 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $674K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 153.2 | 290.8 | 193.8 | 231.2 | 4622 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $794K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 179.2 | 356.0 | 237.4 | 242.5 | 5086 | 4 | 90791 90792 90832 90834 90837 90846 90847 90853 99211 99213 99214 H0034 H0038 H2014 T1016 | $1.0M |
| Nov 2024 | More hours than a day holds, even counting one unit per claim line | 139.9 | 279.2 | 186.1 | 187.3 | 4253 | 4 | 90791 90792 90832 90834 90837 90847 90853 99211 99213 99214 H0038 H2014 T1016 | $787K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DANIEL L KINSEY, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | June 15, 2006, last updated August 24, 2011 |
| Practice location | 330 LAKEVIEW DR, Goshen, IN 46528-9365, 574-533-1234 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, license 01051956A IN) Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, primary, license 01051956A IN) |
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
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H2014 | Skills training and development per 15 minhistory of abuse | $19.6M | 21% | $562 | $298 (top 5% from $3K) | 72nd percentile | |
| 90834 | Psychotherapy, 45 minutes | $17.1M | 18% | $164 | $101 (top 5% from $318) | 77th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $11.8M | 13% | $201 | $60 (top 5% from $332) | 90th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $7.6M | 8% | $124 | $60 (top 5% from $133) | 93rd percentile | |
| T1016 | Case management each 15 min | $7.5M | 8% | $172 | $98 (top 5% from $507) | 69th percentile | |
| G0463 | Medicaid service code | $6.4M | 7% | $106 | $73 (top 5% from $142) | 78th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $5.8M | 6% | $169 | $191 (top 5% from $442) | 40th percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $4.4M | 5% | $92 | $130 (top 5% from $458) | 27th percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 216 | 24 | $1K | $29 | $8 | 3.6x | 2.5x (90th percentile 4.6x) |
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
2 providers in Elkhart County, IN carry an indicator in the public record, with $6.5M at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | DAVIESS COUNTY HOSPITAL Goshen, IN, ranked 6619 | $0 |
|
| 5 | SUSAN TACCHERI Elkhart, IN, ranked 10682 | $6.5M |
Recent enforcement in IN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJSentencedJun 18, 2026
Florida Man Sentenced to 36 Months in Prison
As vice president of a dental practice, he submitted claims to Indiana Medicaid falsely billing for hundreds of dental surgeries that were never performed, used patients' personal identifiers without authorization to support the claims, and committed tax evasion to conceal the income.
DOJSentencedFeb 18, 2026
Highland Physician Sentenced to 97 Months in Prison
Cataldi, sole owner of an otolaryngology practice, billed Medicare and private insurance for thousands of balloon sinuplasty procedures that she did not perform, seeking approximately $50 million and being paid almost $20 million.
DOJCivil settlementJan 28, 2026
Settlement for $1.7 Million With Former Physician Don J. Wagoner and His Business Entity for Fraudulently Billing the Indiana Medicaid Program
Defendants required patients seeking opioid or pain medicine prescriptions to give a single urine sample, tested it with one inexpensive multiplexed screening kit, and billed Indiana Medicaid $171.27 or more per patient by falsely certifying that nine or more separate samples had been collected and analyzed.
DOJSentencedJan 8, 2026
Indiana Woman Sentenced to 84 Months in Prison
Reese falsely claimed to be a licensed clinical psychologist, used forged documents to obtain employment and stole the identities and license numbers of three medical professionals to enroll in Indiana Medicaid and bill for therapy services.
DOJSentencedOct 3, 2024
Merrillville Doctor Sentenced to Prison and Ordered to Pay Restitution
Farley submitted claims to Medicaid and Medicare falsely representing that he had complex, extended visits with patients at his addiction treatment practice, billing for more than 7,000 services he did not provide.
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.