Providers
SHELLY BETH BAER, LCSW
NPI 1396273272, individual, Paducah, KY, Social Worker, Clinical
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 32 months, but with up to 1329 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 8478, $3.8M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 26.4 | 21.0 | 14.0 | 18.3 | 445 | 1 | 90791 90832 90834 90837 99354 99355 99407 H0038 H2027 | $42K |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 41.3 | 28.4 | 18.9 | 25.1 | 775 | 1 | 90791 90832 90834 90837 99354 99355 99407 H0038 H2027 | $64K |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 25.2 | 23.1 | 15.4 | 21.0 | 447 | 1 | 90791 90832 90834 90837 | $51K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 37.5 | 37.5 | 25.0 | 36.9 | 739 | 2 | 90791 90832 90834 90837 | $90K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 51.9 | 51.8 | 34.6 | 48.4 | 867 | 2 | 90791 90834 90837 | $112K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 61.4 | 59.4 | 39.6 | 53.4 | 1103 | 2 | 90791 90832 90834 90837 96112 96113 96130 96131 | $142K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 56.3 | 55.0 | 36.7 | 52.4 | 1046 | 2 | 90791 90834 90837 96112 96113 99354 | $126K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 54.6 | 49.5 | 33.0 | 46.5 | 1071 | 2 | 90791 90832 90834 90837 96112 96113 96130 99354 | $117K |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 58.3 | 57.3 | 38.2 | 52.1 | 1047 | 2 | 90791 90834 90837 90847 96112 96113 96130 99354 | $132K |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 47.6 | 48.3 | 32.2 | 47.5 | 905 | 2 | 90791 90834 90837 90847 96112 96113 99354 | $115K |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 60.1 | 57.6 | 38.4 | 51.8 | 1130 | 2 | 90791 90832 90834 90837 90847 96112 96113 96130 99354 | $138K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 62.5 | 60.2 | 40.1 | 54.7 | 1213 | 2 | 90791 90832 90834 90837 90847 96112 96113 96130 99354 | $139K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 59.4 | 53.3 | 35.5 | 52.5 | 1235 | 2 | 90791 90832 90834 90837 90847 90853 96112 96113 96130 99354 | $128K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 62.2 | 56.8 | 37.8 | 51.6 | 1234 | 2 | 90791 90832 90834 90837 90847 90853 96112 96113 96130 99354 | $132K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 50.5 | 47.0 | 31.3 | 44.2 | 1126 | 2 | 90791 90832 90834 90837 90853 96112 96113 96130 | $113K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 50.8 | 52.3 | 34.9 | 49.1 | 1210 | 2 | 90791 90832 90834 90837 90853 | $126K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 44.7 | 44.0 | 29.4 | 41.0 | 1085 | 2 | 90791 90832 90834 90837 90846 90853 H2027 | $96K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 54.3 | 51.1 | 34.1 | 45.6 | 1195 | 2 | 90791 90832 90834 90837 90846 90853 H2027 | $123K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 47.3 | 44.3 | 29.6 | 44.1 | 1133 | 2 | 90791 90832 90834 90837 90846 90853 H2027 | $103K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 57.9 | 51.2 | 34.1 | 45.9 | 1287 | 2 | 90791 90832 90834 90837 90846 90853 H2015 H2027 | $124K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 47.0 | 42.8 | 28.5 | 38.6 | 1157 | 2 | 90791 90832 90834 90837 90846 90853 H2015 H2027 | $100K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 38.9 | 36.6 | 24.4 | 35.1 | 1057 | 2 | 90791 90832 90834 90837 90846 90853 H2015 | $89K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 56.1 | 47.2 | 31.5 | 41.4 | 1329 | 2 | 90791 90832 90834 90837 90846 90853 H2015 | $115K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 46.9 | 43.0 | 28.7 | 40.8 | 1114 | 2 | 90791 90832 90834 90837 90846 90853 H2015 | $101K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 46.7 | 43.3 | 28.8 | 40.6 | 1057 | 2 | 90791 90832 90834 90837 90847 90853 | $105K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 27.0 | 24.4 | 16.2 | 22.1 | 664 | 2 | 90791 90832 90834 90837 90847 90853 | $57K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 26.0 | 24.1 | 16.1 | 21.7 | 640 | 2 | 90791 90832 90834 90837 90846 90847 90853 | $58K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 35.1 | 32.8 | 21.9 | 32.8 | 1081 | 2 | 90791 90832 90834 90837 90853 | $75K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 33.3 | 32.7 | 21.8 | 29.4 | 834 | 1 | 90791 90832 90834 90837 90853 | $78K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 30.6 | 29.5 | 19.7 | 27.7 | 795 | 1 | 90791 90832 90834 90837 90853 | $70K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 33.7 | 33.2 | 22.1 | 31.6 | 866 | 1 | 90791 90832 90834 90837 90853 | $76K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 35.8 | 35.4 | 23.6 | 31.8 | 927 | 1 | 90791 90832 90834 90837 90853 | $84K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SHELLY BETH BAER, LCSW |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | May 23, 2017, last updated September 20, 2024 |
| Practice location | 2327 NEW HOLT RD, Paducah, KY 42001-7404, 270-534-5128 |
| Mailing address | 5050 VILLAGE SQUARE DR STE B, Paducah, KY 42001-7552 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license 252437 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
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $2.9M | 26% | $125 | $191 (top 5% from $442) | 20th percentile | |
| H0031 | Medicaid service code | $2.0M | 18% | $110 | $100 (top 5% from $540) | 55th percentile | |
| H2020 | Therapeutic behavioral services per diem | $1.4M | 12% | $1K | $455 (top 5% from $2K) | 83rd percentile | |
| H0032 | Medicaid service code | $985K | 9% | $108 | $98 (top 5% from $675) | 54th percentile | |
| T2023 | Medicaid service code | $957K | 8% | $385 | $332 (top 5% from $1K) | 71st percentile | |
| 90791 | Psychiatric diagnostic evaluation | $590K | 5% | $90 | $105 (top 5% from $228) | 36th percentile | |
| H0002 | Medicaid service code | $518K | 5% | $131 | $34 (top 5% from $215) | 87th percentile | |
| 90887 | Medicaid service code | $347K | 3% | $62 | $98 (top 5% from $270) | 23rd 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 |
|---|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 1,152 | 209 | $93K | $203 | $108 | 1.9x | 1.6x (90th percentile 2.9x) |
| 90791 | Psychiatric diagnostic evaluation | 163 | 161 | $14K | $208 | $120 | 1.7x | 1.9x (90th percentile 3.6x) |
| 90832 | Psychotherapy, 30 minutes | 56 | 42 | $2K | $102 | $55 | 1.9x | 2.0x (90th percentile 3.5x) |
| 90834 | Psychotherapy, 45 minutes | 45 | 26 | $2K | $136 | $72 | 1.9x | 2.0x (90th percentile 3.6x) |
| 90853 | Group psychotherapy | 144 | 18 | $2K | $40 | $20 | 2.0x | 4.0x (90th percentile 7.8x) |
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
7 providers in McCracken County, KY carry an indicator in the public record, with $5.4M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | BAPTIST HEALTH HOME CARE KY LLC Paducah, KY, ranked 2409 | $0 |
|
| 3 | PROVIDENCE POINT HEALTHCARE, INC. Paducah, KY, ranked 5958 | $0 |
|
| 4 | LAURIE BALLEW Paducah, KY, ranked 7655 | $2.3M |
|
| 4 | GRETCHEN ROOF Paducah, KY, ranked 8664 | $2.3M |
|
| 4 | SAMANTHA JONES Paducah, KY, ranked 9288 | $387K |
|
| 4 | DEREK RATLIFF Paducah, KY, ranked 9317 | $349K |
|
| 5 | DANIEL SUSSMAN Paducah, KY, ranked 11593 | $124K |
Recent enforcement in KY
All releasesDepartment 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
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.