Providers
All 16 in TX
RAUL R CAPITAINE, MD
NPI 1568457315, individual, Corpus Christi, TX, Psychiatry & Neurology, Psychiatry
1
Evidence tier
documented action, then payment
- Listed on the TX Medicaid exclusion list since October 15, 2021.
- Medicaid still paid claims in 1 later month, $7,752 in total.
score 94 of 100, rank 303, $8K at stake
Public list actions
OIG exclusion January 18, 2024 under section 1128b4
Physician (MD, DO), Psychiatry, Corpus Christi, TX
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| TX Medicaid exclusion list texas hhsc oig exclusions file (sept 5 2026) | Exact NPI, name verified | Oct 15, 2021 | still open | 1 | Nov 2021 | Nov 2021 | $8K | $326K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RAUL R CAPITAINE, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | September 19, 2005, last updated October 1, 2013 |
| Practice location | 6000 S STAPLES ST, #406, Corpus Christi, TX 78413-2952, 361-993-4835 |
| Mailing address | PO BOX 271190, Corpus Christi, TX 78427-1190 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license H4885 TX) |
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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $396K | 86% | $43 | $60 (top 5% from $133) | 28th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $55K | 12% | $26 | $44 (top 5% from $110) | 23rd percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $5K | 1% | $20 | $49 (top 5% from $109) | 16th percentile | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $4K | 1% | $28 | $88 (top 5% from $210) | too few months to rank | |
| G0408 | Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth | $3K | 1% | $31 | $10 (top 5% from $148) | too few months to rank |
In this area
16 providers in Nueces County, TX carry an indicator in the public record, with $20.7M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by part of a provider network on 7.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | HUB CITY HOME HEALTH INC Corpus Christi, TX, ranked 817 | $9.3M |
|
| 3 | REHMET HOLDINGS LLC Corpus Christi, TX, ranked 2967 | $0 |
|
| 3 | APC HOME HEALTH SERVICE, INC. Corpus Christi, TX, ranked 5377 | $0 |
|
| 3 | CIMA HOSPICE OF CORPUS CHRISTI, LLC Corpus Christi, TX, ranked 6503 | $0 |
|
| 3 | TRIO HOME HEALTH INC, Corpus Christi, TX, ranked 6549 | $0 |
|
| 3 | CORPUS CHRISTI HOME CARE, INC. Corpus Christi, TX, ranked 6611 | $0 |
|
| 3 | TRIO HOSPICE INC Corpus Christi, TX, ranked 7111 | $0 |
|
| 4 | MICHAEL HERNANDEZ Corpus Christi, TX, ranked 7296 | $3.1M |
|
Recent enforcement in TX
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementAug 26, 2026
Dallas medical clinic to pay $7.5 million to resolve COVID-19 testing overbilling allegations
Aymancare billed the federal government's HRSA Uninsured Program for separate evaluation and management services in addition to COVID-19 specimen collection and testing at pop-up testing sites when no such separate services were performed.
DOJConvictedAug 12, 2026
Scammer pharmacist guilty in $20 million healthcare kickback scheme
Thomas paid over $2 million in kickbacks to the owner of a Houston clinic in exchange for referrals of DOL-OWCP insured patients prescribed high-reimbursement compounded medications, which his pharmacy then billed to DOL-OWCP, receiving more than $20 million in reimbursements.
DOJIndictedJun 24, 2026
U.S. Attorney Announces Major Health Care Fraud Cases in Western District of Texas
Charles is alleged to have received illegal kickbacks for referring patients to San Antonio area hospice companies, causing over $9 million in Medicare claims, while Dr. Duncan settled allegations of billing Medicare and TRICARE for an unapproved amniotic-based product and Trevor's Place settled allegations of submitting inflated TRICARE claims for services not provided.
DOJIndictedJun 23, 2026
Nine charged in SDTX as part of national health care fraud takedown
Nine defendants were indicted in the Southern District of Texas for operating pill mill clinics and a pharmacy that unlawfully distributed controlled substances, billing Medicaid $16 million for mental health services for minors that did not occur, and billing Medicare and TRICARE approximately $906 million for medically unnecessary amniotic wound allografts procured through kickbacks.
DOJChargedJun 23, 2026
Northern District of Texas Charges 13 Health Care Fraudsters for Loss Over $360 Million
Thirteen defendants in the Northern District of Texas were charged in seven cases involving more than $365 million in fraudulent billing to federally-funded programs and other insurers, including laboratory and genetic testing claims procured through kickbacks, transcranial magnetic stimulation treatments billed to TRICARE, medically unnecessary EEG testing, and hospice services never provided.
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.