SEAN N KALEY, MD
NPI 1366676751, individual, Fayetteville, AR, Psychiatry & Neurology, Psychiatry
- Hours beyond a day in 3 months, but with up to 219 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 90833 ($139 per patient-month) sit in the top 5% of every provider billing that code.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Mar 2018 | More hours than a day holds, even counting one unit per claim line | 24.4 | 24.1 | 16.0 | 22.6 | 213 | 1 | 90833 99223 99232 99233 | $35K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 25.4 | 25.0 | 16.7 | 22.5 | 208 | 1 | 90833 99223 99232 99233 | $36K |
| Jun 2018 | More hours than a day holds, even counting one unit per claim line | 25.5 | 25.2 | 16.8 | 24.0 | 199 | 1 | 90833 99223 99232 99233 | $35K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SEAN N KALEY, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | May 13, 2009, last updated February 26, 2020 |
| Practice location | 4253 N CROSSOVER RD, Fayetteville, AR 72703-4593, 479-551-9840 |
| Mailing address | 11401 N RODNEY PARHAM, STE 4, Little Rock, AR 72212 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license e7836 AR) |
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 | |
|---|---|---|---|---|---|---|---|
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $79K | 35% | $139 | $49 (top 5% from $109) | 97th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $78K | 34% | $118 | $67 (top 5% from $174) | 84th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $26K | 11% | $136 | $81 (top 5% from $170) | 88th percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $20K | 9% | $90 | $96 (top 5% from $249) | 45th percentile | |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | $16K | 7% | $34 | $37 (top 5% from $103) | 43rd percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $4K | 2% | $77 | $112 (top 5% from $313) | too few months to rank | |
| 90791 | Psychiatric diagnostic evaluation | $3K | 1% | $113 | $105 (top 5% from $228) | too few months to rank | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1K | 1% | $39 | $44 (top 5% from $110) | too few months to rank |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 162 | 48 | $9K | $120 | $72 | 1.7x | 2.6x (90th percentile 4.3x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 52 | 41 | $4K | $175 | $108 | 1.6x | 2.6x (90th percentile 4.7x) |
| 90792 | Psychiatric diagnostic evaluation with medical services | 32 | 31 | $4K | $240 | $160 | 1.5x | 2.2x (90th percentile 3.9x) |
| 99238 | Hospital discharge day management, 30 minutes or less | 23 | 22 | $1K | $115 | $73 | 1.6x | 2.6x (90th percentile 4.7x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 26 | 15 | $1K | $110 | $60 | 1.8x | 2.1x (90th percentile 3.5x) |
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
3 providers in Washington County, AR carry an indicator in the public record, with $1.1M at stake between them. The most common is paid after a public list action, on 2 of them, followed by more hours than a day holds on 1. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ADAM MAASS Springdale, AR, ranked 305 | $7K |
|
| 1 | HANNAH HARRIS Fayetteville, AR, ranked 307 | $7K |
|
| 4 | VASHONDA EASON Springdale, AR, ranked 8183 | $1.0M |
|
Recent enforcement in AR
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.