ANDREW JAMES MILLER, PsyD, HSPP
NPI 1619992757, individual, Fort Wayne, IN, Psychologist, Clinical
- Billed more hands-on hours than a day holds in 1 month, peaking at 21.8 hours per day across 3 billing organizations.
- 85% of Medicaid dollars are on codes with a history of abuse.
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 |
|---|---|---|---|---|---|---|---|---|---|
| May 2023 | More hours than a day holds, even counting one unit per claim line | 29.5 | 32.7 | 21.8 | 29.3 | 334 | 3 | 90791 90837 | $79K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ANDREW JAMES MILLER, PsyD, HSPP |
| Type | Individual |
| Status | Active |
| NPI issued | July 12, 2006, last updated April 18, 2024 |
| Practice location | 12948 COLDWATER RD STE 101, Fort Wayne, IN 46845-8016, 260-373-0880 |
| Mailing address | 1605 ALABAMA AVE, Fort Wayne, IN 46805-5011 |
| Specialties | Counselor, Mental Health (101YM0800X, license 39001777A IN) Psychologist, Clinical (103TC0700X, primary, license 20042470A IN) |
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 | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $2.0M | 67% | $207 | $191 (top 5% from $442) | 57th percentile | |
| 97153 | Adaptive behavior treatment by protocol by technicianhistory of abuse | $428K | 14% | $5K | $2K (top 5% from $6K) | 89th percentile | |
| 96152 | Health and behavior intervention individual each 15 min (pre-2020) | $290K | 10% | $4K | $40 (top 5% from $2K) | too few months to rank | |
| 97155 | Adaptive behavior treatment with protocol modification by QHPhistory of abuse | $114K | 4% | $1K | $512 (top 5% from $1K) | 89th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $111K | 4% | $109 | $105 (top 5% from $228) | 55th percentile | |
| 90785 | Psychiatric services complicated by communication factor | $36K | 1% | $19 | $15 (top 5% from $35) | 62nd percentile | |
| 90834 | Psychotherapy, 45 minutes | $5K | 0% | $90 | $101 (top 5% from $318) | too few months to rank | |
| 90832 | Psychotherapy, 30 minutes | $2K | 0% | $73 | $59 (top 5% from $239) | 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 |
|---|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 221 | 26 | $25K | $175 | $145 | 1.2x | 1.6x (90th percentile 2.9x) |
| 90791 | Psychiatric diagnostic evaluation | 17 | 17 | $2K | $225 | $164 | 1.4x | 1.9x (90th percentile 3.6x) |
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
27 providers in Allen County, IN carry an indicator in the public record, with $88.7M at stake between them. The most common is part of a provider network, on 14 of them, followed by more hours than a day holds on 13.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY Fort Wayne, IN, ranked 2139 | $0 |
|
| 3 | LUMINARY HOSPICE OF FORT WAYNE, LLC Fort Wayne, IN, ranked 2237 | $0 |
|
| 3 | ADAMS COUNTY MEMORIAL HOSPITAL Fort Wayne, IN, ranked 2503 | $0 |
|
| 3 | PULASKI MEMORIAL HOSPITAL Fort Wayne, IN, ranked 4486 | $0 |
|
| 3 | ADAMS COUNTY MEMORIAL HOSPITAL Monroeville, IN, ranked 4530 | $0 |
|
| 3 | ADAMS COUNTY MEMORIAL HOSPITAL Fort Wayne, IN, ranked 4534 | $0 |
|
| 3 | PULASKI MEMORIAL HOSPITAL Fort Wayne, IN, ranked 4848 | $0 |
|
| 3 | ADAMS COUNTY MEMORIAL HOSPITAL Fort Wayne, IN, ranked 5175 | $0 |
|
Recent enforcement in IN
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.