Providers
All 17 in KY
TERRY NELSON, LCSW
NPI 1518388321, individual, Somerset, KY, Social Worker, Clinical
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 79 months, but with up to 1850 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 8293, $10.3M 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 | 47.9 | 50.8 | 33.9 | 45.7 | 1038 | 1 | 90832 90837 90847 99354 99355 | $99K |
| Feb 2018 | More hours than a day holds, even counting one unit per claim line | 44.3 | 46.2 | 30.8 | 43.1 | 927 | 1 | 90832 90834 90837 90847 99354 | $85K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 44.7 | 46.8 | 31.2 | 42.0 | 1028 | 1 | 90832 90837 90847 99354 99355 | $91K |
| Jun 2018 | More hours than a day holds, even counting one unit per claim line | 57.7 | 61.4 | 40.9 | 58.5 | 1196 | 1 | 90832 90837 90847 99354 99355 | $114K |
| Jul 2018 | More hours than a day holds, even counting one unit per claim line | 70.8 | 71.5 | 47.7 | 67.2 | 1299 | 1 | 90832 90837 90847 99354 99355 | $137K |
| Aug 2018 | More hours than a day holds, even counting one unit per claim line | 76.9 | 83.3 | 55.5 | 74.9 | 1458 | 1 | 90832 90834 90837 90847 99354 99355 | $163K |
| Sep 2018 | More hours than a day holds, even counting one unit per claim line | 78.8 | 80.6 | 53.8 | 80.6 | 1393 | 1 | 90832 90834 90837 90847 99354 99355 | $153K |
| Oct 2018 | More hours than a day holds, even counting one unit per claim line | 51.1 | 54.0 | 36.0 | 48.5 | 1088 | 1 | 90832 90834 90837 90847 99354 99355 | $107K |
| Nov 2018 | More hours than a day holds, even counting one unit per claim line | 53.1 | 56.0 | 37.3 | 50.9 | 1114 | 1 | 90832 90834 90837 90847 99354 | $106K |
| Dec 2018 | More hours than a day holds, even counting one unit per claim line | 67.8 | 71.7 | 47.8 | 70.6 | 1292 | 1 | 90832 90834 90837 90847 99354 | $140K |
| Jan 2019 | More hours than a day holds, even counting one unit per claim line | 89.3 | 86.4 | 57.6 | 77.6 | 1572 | 1 | 90832 90834 90837 90847 99354 99355 | $183K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 79.6 | 82.0 | 54.6 | 76.5 | 1442 | 1 | 90832 90834 90837 90847 99354 99355 | $154K |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 80.7 | 83.7 | 55.8 | 82.4 | 1590 | 1 | 90832 90834 90837 90847 99354 99355 | $175K |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 90.0 | 88.1 | 58.7 | 80.1 | 1555 | 1 | 90832 90834 90837 90847 99354 99355 | $178K |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 88.6 | 91.5 | 61.0 | 82.2 | 1586 | 1 | 90832 90834 90837 90847 99354 99355 | $190K |
| Jun 2019 | More hours than a day holds, even counting one unit per claim line | 74.1 | 78.8 | 52.5 | 78.8 | 1370 | 1 | 90832 90834 90837 90847 99354 99355 | $157K |
| Jul 2019 | More hours than a day holds, even counting one unit per claim line | 91.9 | 98.5 | 65.6 | 88.5 | 1581 | 1 | 90832 90834 90837 90847 99354 99355 | $203K |
| Aug 2019 | More hours than a day holds, even counting one unit per claim line | 75.5 | 81.8 | 54.6 | 76.9 | 1468 | 1 | 90832 90834 90837 90847 99354 99355 | $170K |
| Sep 2019 | More hours than a day holds, even counting one unit per claim line | 83.1 | 88.7 | 59.1 | 84.4 | 1551 | 1 | 90832 90834 90837 90847 99354 99355 | $180K |
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 93.3 | 100.8 | 67.2 | 90.5 | 1694 | 1 | 90832 90834 90837 90847 99354 99355 | $210K |
| Nov 2019 | More hours than a day holds, even counting one unit per claim line | 93.2 | 98.8 | 65.8 | 94.1 | 1663 | 1 | 90832 90834 90837 90847 99354 99355 | $200K |
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 62.0 | 67.8 | 45.2 | 63.7 | 1381 | 1 | 90832 90834 90837 90847 99354 99355 | $141K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 71.2 | 64.5 | 43.0 | 58.0 | 1300 | 1 | 90832 90834 90837 90847 99354 99355 | $142K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 130.7 | 122.6 | 81.7 | 118.5 | 1850 | 1 | 90832 90834 90837 90847 99354 99355 | $252K |
| Mar 2020 | More hours than a day holds, even counting one unit per claim line | 89.2 | 84.8 | 56.5 | 79.7 | 1575 | 1 | 90832 90834 90837 90847 99354 99355 | $187K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 53.2 | 50.7 | 33.8 | 46.1 | 1053 | 1 | 90832 90834 90837 90847 99354 | $109K |
| May 2020 | More hours than a day holds, even counting one unit per claim line | 44.4 | 46.1 | 30.7 | 45.3 | 989 | 1 | 90832 90834 90837 90847 99354 | $102K |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 56.5 | 57.1 | 38.1 | 51.9 | 1174 | 2 | 90832 90834 90837 90847 99354 | $122K |
| Jul 2020 | More hours than a day holds, even counting one unit per claim line | 59.3 | 59.6 | 39.7 | 53.5 | 1251 | 2 | 90832 90834 90837 90847 99354 99355 | $132K |
| Aug 2020 | More hours than a day holds, even counting one unit per claim line | 62.3 | 63.9 | 42.6 | 62.8 | 1307 | 2 | 90832 90834 90837 90847 99354 99355 | $142K |
| Sep 2020 | More hours than a day holds, even counting one unit per claim line | 61.3 | 63.7 | 42.5 | 57.9 | 1261 | 2 | 90832 90834 90837 90847 99354 | $136K |
| Oct 2020 | More hours than a day holds, even counting one unit per claim line | 50.6 | 52.9 | 35.2 | 49.7 | 1137 | 1 | 90832 90834 90837 90847 99354 99355 | $118K |
| Nov 2020 | More hours than a day holds, even counting one unit per claim line | 48.0 | 49.8 | 33.2 | 47.4 | 1042 | 1 | 90832 90834 90837 90847 99354 | $107K |
| Dec 2020 | More hours than a day holds, even counting one unit per claim line | 49.6 | 50.6 | 33.7 | 45.4 | 1095 | 2 | 90832 90834 90837 90847 99354 | $112K |
| Jan 2021 | More hours than a day holds, even counting one unit per claim line | 45.8 | 48.1 | 32.1 | 47.3 | 1011 | 2 | 90832 90834 90837 90847 99354 | $106K |
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 44.6 | 47.0 | 31.3 | 43.9 | 1006 | 2 | 90832 90834 90837 90847 99354 | $94K |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 44.5 | 47.1 | 31.4 | 42.3 | 995 | 1 | 90832 90834 90837 90847 99354 | $104K |
| Apr 2021 | More hours than a day holds, even counting one unit per claim line | 39.8 | 39.7 | 26.5 | 36.1 | 965 | 2 | 90832 90834 90837 90847 99354 | $85K |
| May 2021 | More hours than a day holds, even counting one unit per claim line | 37.6 | 40.0 | 26.7 | 39.3 | 921 | 2 | 90832 90834 90837 90847 99354 | $88K |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 45.3 | 47.6 | 31.7 | 43.3 | 947 | 2 | 90832 90834 90837 90847 99354 | $102K |
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 33.8 | 36.3 | 24.2 | 34.1 | 783 | 2 | 90832 90834 90837 99354 | $79K |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 30.7 | 33.9 | 22.6 | 31.9 | 789 | 2 | 90832 90834 90837 90847 99354 | $74K |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 27.5 | 29.2 | 19.5 | 26.5 | 716 | 2 | 90791 90832 90834 90837 90847 99354 | $62K |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 34.0 | 36.1 | 24.0 | 35.5 | 916 | 2 | 90832 90834 90837 90847 99354 | $80K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 38.7 | 43.9 | 29.3 | 39.9 | 969 | 2 | 90832 90834 90837 90847 99354 | $94K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 38.9 | 44.7 | 29.8 | 40.1 | 943 | 2 | 90832 90834 90837 90847 99354 | $98K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 38.6 | 40.5 | 27.0 | 39.9 | 932 | 2 | 90832 90834 90837 90847 99354 | $95K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 46.7 | 48.5 | 32.3 | 45.2 | 1058 | 2 | 90832 90834 90837 99354 | $103K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 50.5 | 52.7 | 35.1 | 47.4 | 1185 | 2 | 90832 90834 90837 90847 99354 | $124K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 42.8 | 45.1 | 30.1 | 42.9 | 973 | 2 | 90832 90834 90837 90847 99354 | $102K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 56.2 | 59.0 | 39.4 | 55.5 | 1220 | 1 | 90832 90834 90837 90847 99354 | $138K |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 65.2 | 68.3 | 45.5 | 62.1 | 1294 | 2 | 90832 90834 90837 90847 99354 99355 | $155K |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 27.8 | 29.4 | 19.6 | 28.9 | 699 | 2 | 90832 90834 90837 90847 99354 | $69K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 49.3 | 38.8 | 25.8 | 31.7 | 927 | 1 | 90791 90832 90834 90837 90847 99354 H2015 | $95K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 43.8 | 43.0 | 28.7 | 39.7 | 1075 | 1 | 90791 90832 90834 90837 90847 99354 H2015 | $107K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 39.1 | 39.1 | 26.1 | 33.1 | 1001 | 1 | 90791 90832 90834 90837 99354 H2015 | $94K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 33.1 | 33.9 | 22.6 | 28.7 | 972 | 1 | 90791 90832 90834 90837 90853 99354 H2015 | $84K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 47.2 | 45.5 | 30.4 | 40.6 | 1099 | 1 | 90791 90832 90834 90837 H2015 | $113K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 51.5 | 49.3 | 32.9 | 42.4 | 1180 | 1 | 90791 90832 90834 90837 90847 90853 H2015 | $112K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 54.0 | 53.1 | 35.4 | 43.1 | 1314 | 1 | 90791 90832 90834 90837 90847 90853 H2015 | $135K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 44.0 | 43.2 | 28.8 | 37.2 | 1222 | 1 | 90791 90832 90834 90837 90847 90853 H2015 | $109K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 49.2 | 48.5 | 32.3 | 36.1 | 1364 | 1 | 90791 90832 90834 90837 90846 90847 90853 H2015 | $128K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 44.7 | 47.3 | 31.6 | 29.5 | 968 | 1 | 90791 90832 90834 90837 H2015 | $131K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 33.9 | 33.6 | 22.4 | 23.2 | 805 | 1 | 90791 90832 90834 90837 90853 H2015 | $95K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 51.1 | 47.8 | 31.9 | 40.2 | 1238 | 1 | 90791 90832 90834 90837 90846 H0004 H2015 | $120K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 54.0 | 51.7 | 34.4 | 45.2 | 1294 | 1 | 90791 90832 90834 90837 H0004 H2015 | $127K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 56.8 | 53.6 | 35.8 | 46.2 | 1353 | 1 | 90791 90832 90834 90837 90846 90853 H2015 | $135K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 51.5 | 49.3 | 32.8 | 40.5 | 1355 | 1 | 90791 90832 90834 90837 90853 H2015 | $121K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 39.1 | 40.5 | 27.0 | 31.6 | 1269 | 1 | 90791 90832 90834 90837 90846 90853 H0038 H2015 | $105K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 50.5 | 50.2 | 33.5 | 39.4 | 1308 | 1 | 90791 90832 90834 90837 90846 90853 H0038 H2015 | $123K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 71.5 | 72.7 | 48.5 | 55.9 | 1732 | 1 | 90791 90832 90834 90837 90846 90853 H0038 H2015 | $171K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 65.8 | 64.9 | 43.3 | 54.9 | 1690 | 1 | 90791 90832 90834 90837 90847 90853 H2015 | $164K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 68.4 | 70.3 | 46.9 | 52.8 | 1708 | 1 | 90791 90832 90834 90837 90847 90853 H2015 | $173K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 62.3 | 64.4 | 42.9 | 47.9 | 1582 | 1 | 90791 90832 90834 90837 90846 90847 90853 H2015 | $163K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 60.3 | 76.3 | 50.9 | 47.5 | 1229 | 1 | 90791 90832 90834 90837 90847 H0004 H2015 | $201K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 48.5 | 64.9 | 43.3 | 32.6 | 1116 | 1 | 90791 90832 90834 90837 90847 90853 H0004 H2015 | $180K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 54.3 | 57.4 | 38.3 | 43.1 | 1449 | 1 | 90791 90832 90834 90837 90846 90847 H2015 | $147K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 58.2 | 60.8 | 40.5 | 46.3 | 1396 | 1 | 90791 90832 90834 90837 90846 H0004 H2015 | $151K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 76.0 | 79.0 | 52.7 | 55.3 | 1801 | 1 | 90791 90832 90834 90837 90846 90853 H0004 H2015 | $204K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | TERRY NELSON, LCSW |
| Type | Individual |
| Status | Active |
| NPI issued | December 20, 2013, last updated December 20, 2013 |
| Practice location | 401 BOGLE ST, SUITE 102, Somerset, KY 42503-3823, 606-676-0638 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license 3421 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 | |
|---|---|---|---|---|---|---|---|
| T2023 | Medicaid service code | $11.4M | 50% | $324 | $332 (top 5% from $1K) | 43rd percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $6.8M | 30% | $129 | $191 (top 5% from $442) | 22nd percentile | |
| 99354 | Prolonged service outpatient first hour (retired 2023) | $1.2M | 5% | $95 | $78 (top 5% from $222) | 61st percentile | |
| 90832 | Psychotherapy, 30 minutes | $930K | 4% | $56 | $59 (top 5% from $239) | 47th percentile | |
| H2015 | Comprehensive community support services per 15 minhistory of abuse | $800K | 4% | $144 | $344 (top 5% from $2K) | 29th percentile | |
| H0032 | Medicaid service code | $477K | 2% | $63 | $98 (top 5% from $675) | 24th percentile | |
| 90887 | Medicaid service code | $387K | 2% | $59 | $98 (top 5% from $270) | 19th percentile | |
| 90834 | Psychotherapy, 45 minutes | $258K | 1% | $57 | $101 (top 5% from $318) | 23rd percentile |
In this area
17 providers in Pulaski County, KY carry an indicator in the public record, with $38.7M at stake between them. The most common is more hours than a day holds, on 16 of them, followed by named in an enforcement record on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | SCIENCE HILL FAMILY CARE Science Hill, KY, ranked 605 | $0 |
|
| 4 | ANASTACIA HUDGINS Somerset, KY, ranked 7329 | $883K |
|
| 4 | SARAH JARVIS Somerset, KY, ranked 8159 | $1.3M |
|
| 4 | SHANAE CARPENTER Somerset, KY, ranked 8294 | $10.0M |
|
| 4 | THERESA RUST Somerset, KY, ranked 8306 | $9.0M |
|
| 4 | KASEY COMPTON Somerset, KY, ranked 8444 | $4.3M |
|
| 4 | CHRISTY RAINWATER Nancy, KY, ranked 8493 | $3.6M |
|
| 4 | NATHAN FISHER Somerset, KY, ranked 8768 | $1.8M |
|
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.