MELISSA ANNETTE POWELL, LCSW-C

NPI 1578873733, individual, Baltimore, MD, Social Worker, Clinical

Evidence tier

structure or single-organization volume

Hours beyond a day in 1 month under one organization, which can be supervisory billing.
Records needed.

score 51 of 100, rank 9327, $332K 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
Dec 2020	More hours than a day holds, even counting one unit per claim line	24.4	12.3	8.2	11.0	186	1	90791 90834 90847	$39K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	MELISSA ANNETTE POWELL, LCSW-C
Type	Individual, sole proprietor
Status	Active
NPI issued	October 20, 2010, last updated October 4, 2020
Practice location	1900 E NORTHERN PKWY STE T5, Baltimore, MD 21239-2120, 410-645-1000
Mailing address	4205 MARY AVE, Baltimore, MD 21206-2620
Specialties	Social Worker, Clinical (1041C0700X, primary, license 15042 MD)

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
90834	Psychotherapy, 45 minutes	$1.5M	92%	$210	$101 (top 5% from $318)	86th percentile
90791	Psychiatric diagnostic evaluation	$98K	6%	$133	$105 (top 5% from $228)	75th percentile
90832	Psychotherapy, 30 minutes	$14K	1%	$88	$59 (top 5% from $239)	75th percentile
90847	Family psychotherapy with patient, 50 minutes	$13K	1%	$116	$130 (top 5% from $458)	42nd 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
90834	Psychotherapy, 45 minutes	512	29	$31K	$150	$79	1.9x	2.0x (90th percentile 3.6x)
90832	Psychotherapy, 30 minutes	45	11	$2K	$100	$60	1.7x	2.0x (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

9 providers in Baltimore city County, MD carry an indicator in the public record, with $6.1M at stake between them. The most common is more hours than a day holds, on 4 of them, followed by named in an enforcement record on 3. 3 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	GUIDING LIVES Baltimore, MD, ranked 57	$1.4M	Adjudicated (sentenced) per a state attorney general release dated December 8, 2025. Medicaid paid $1,358,665 in the last 12 observed months.
1	ANOTHER CHANCE SUPPORTIVE SERVICES Baltimore, MD, ranked 67	$874K	Adjudicated (sentenced) per a state attorney general release dated December 8, 2025. Medicaid paid $873,505 in the last 12 observed months.
1	GUIDING LIVES Baltimore, MD, ranked 631	$0	Adjudicated (sentenced) per a state attorney general release dated December 8, 2025. No Medicaid payments in the last 12 observed months.
2	ABENA ADOKO SANDO Baltimore, MD, ranked 704	$581K	Billed more hands-on hours than a day holds in 4 months, peaking at 23.0 hours per day across 3 billing organizations. Medicaid dollars per patient on code 90834 ($382 per patient-month) sit in the top 5% of every provider billing that code.
4	WALTER TOLLER Baltimore, MD, ranked 7947	$480K	Hours beyond a day in 2 months, but with up to 1173 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed. and 1 more
4	TANYA PEETE Baltimore, MD, ranked 8625	$2.5M	Hours beyond a day in 12 months, but with up to 737 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed.
5	FLORENCE EZE Baltimore, MD, ranked 11388	$279K
5	BALTIMORE HEALTH CARE P.C Baltimore, MD, ranked 11937	$9K

All 9 in MD

Recent enforcement in MD

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementMar 20, 2026

Health Care Management Corporation Agrees to Pay $4 Million to Resolve False Claims Act Allegations

CVR knowingly submitted claims to Medicare, Medicaid, and TRICARE for sclerotherapy, radiofrequency ablation, and endovenous laser ablation procedures to treat chronic venous insufficiency that were not clinically indicated and were medically unnecessary between January 1, 2010, and December 31, 2016.

DOJCivil settlementNov 20, 2025

Diagnostic Laboratory Agrees to Pay More Than $1 Million to Settle Alleged False Claims Act Violations

GTI agreed to pay $1.635 million to resolve allegations that it submitted Medicare claims for respiratory pathogen panels that were medically unnecessary or obtained through kickbacks paid under a marketing services agreement with an infection prevention company for laboratory test referrals from long-term care facilities.

DOJSentencedNov 13, 2025

Baltimore County Woman Sentenced for Impersonating Nurses and Aggravated Identity Theft

Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland that billed health care benefit programs including Medicare and Medicaid for services she provided, earning more than $145,000 in wages.

DOJPleaded guiltyAug 14, 2025

Baltimore County Woman Admits to Impersonating Nurses, Pleads Guilty to Aggravated Identity Theft

Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland, which billed health care benefit programs including Medicare and Medicaid for services she provided.

DOJCivil judgmentAug 11, 2025

United States Obtains More Than $1.4 Million Judgment Against Family Medical Practitioner for Fraudulent Billing

Akoto billed Medicare for auricular stimulation (P-Stim) devices using a code for a surgically implanted neurostimulator device, which Medicare does not reimburse as acupuncture.

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.

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