Providers

LAURIE KAY BALLEW, D.O.

NPI 1639141948, individual, Paducah, KY, Psychiatry & Neurology, Psychiatry

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 7 months, but with up to 1278 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • Medicaid dollars per patient on code G0482 ($256 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7655, $2.3M 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jun 2022More hours than a day holds, even counting one unit per claim line26.930.220.127.51001290833 90834 90837 99204 99213 99214$71K
Jul 2022More hours than a day holds, even counting one unit per claim line26.029.920.029.51034290833 90834 90837 99204 99213 99214 99354$72K
Aug 2022More hours than a day holds, even counting one unit per claim line34.738.225.534.31154290833 90837 96112 96113 99204 99213 99214 99354$92K
Sep 2022More hours than a day holds, even counting one unit per claim line32.738.125.434.71183290832 90833 90837 99204 99213 99214 99354$89K
Oct 2022More hours than a day holds, even counting one unit per claim line31.236.424.235.81167290832 90833 90837 96112 96113 99204 99213 99214 99354$87K
Nov 2022More hours than a day holds, even counting one unit per claim line29.334.623.131.51120290832 90833 90837 99204 99213 99214$81K
Dec 2022More hours than a day holds, even counting one unit per claim line24.831.120.829.3980190833 90837 96112 96113 99204 99213 99214$75K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameLAURIE KAY BALLEW, D.O.
TypeIndividual
StatusActive
NPI issuedFebruary 2, 2006, last updated September 20, 2024
Practice location2520 NEW HOLT RD STE I, Paducah, KY 42001-7547, 270-558-3916
Mailing addressPO BOX 636961, Cincinnati, OH 45263-6961
Specialties
Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 02436 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$788K15%$74$60 (top 5% from $133)65th percentile
G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms$726K14%$256$133 (top 5% from $245)96th percentile
80307Testing for presence of drug, by chemistry analyzers$656K13%$66$45 (top 5% from $110)77th percentile
90833Psychotherapy with evaluation and management visit, 30 minutes$598K12%$47$49 (top 5% from $109)47th percentile
G0483Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms$512K10%$175$146 (top 5% from $318)66th percentile
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms$447K9%$107$98 (top 5% from $199)56th percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$409K8%$50$44 (top 5% from $110)59th percentile
90837Psychotherapy, 1 hourhistory of abuse$277K5%$137$191 (top 5% from $442)25th percentile
Medicare Part B 2024, largest codes
codewhat it isservicesbeneficiariespaidsubmitted per serviceallowed per servicecharge to allowedusual for this code
90868Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management44213$60K$350$1742.0x3.4x (90th percentile 10.3x)
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more622185$52K$154$1121.4x2.3x (90th percentile 3.8x)
90833Psychotherapy with evaluation and management visit, 30 minutes623193$31K$104$651.6x2.1x (90th percentile 3.5x)
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms10217$15K$300$1432.1x3.1x (90th percentile 6.1x)
80307Testing for presence of drug, by chemistry analyzers18644$11K$120$592.0x3.2x (90th percentile 7.6x)
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more18953$10K$106$771.4x2.2x (90th percentile 3.8x)
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more5353$6K$231$1461.6x2.4x (90th percentile 3.9x)
G0480Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms2919$3K$243$1122.2x2.7x (90th percentile 6.1x)

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 $6.9M 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.

tierproviderat stakewhy
3BAPTIST HEALTH HOME CARE KY LLC
Paducah, KY, ranked 2409
$0
  • Part of provider network D1-00115, ranked 115 nationally.
3PROVIDENCE POINT HEALTHCARE, INC.
Paducah, KY, ranked 5958
$0
  • Part of provider network D1-00059, ranked 59 nationally.
4SHELLY BAER
Paducah, KY, ranked 8478
$3.8M
  • 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.
4GRETCHEN ROOF
Paducah, KY, ranked 8664
$2.3M
  • Hours beyond a day in 2 months, but with up to 711 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4SAMANTHA JONES
Paducah, KY, ranked 9288
$387K
  • Hours beyond a day in 4 months, but with up to 791 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4DEREK RATLIFF
Paducah, KY, ranked 9317
$349K
  • Hours beyond a day in 3 months, but with up to 1162 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5DANIEL SUSSMAN
Paducah, KY, ranked 11593
$124K

Recent enforcement in KY

All releases

Department 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

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