DOUGLAS JAMES HESS, D.O.
NPI 1679864441, individual, Fargo, ND, Psychiatry & Neurology, Child & Adolescent Psychiatry
- Medicaid dollars per patient on code 99233 ($339 per patient-month) sit in the top 5% of every provider billing that code.
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DOUGLAS JAMES HESS, D.O. |
| Type | Individual |
| Status | Active |
| NPI issued | April 27, 2011, last updated February 16, 2024 |
| Practice location | 4541 52ND AVE S, STE 100, Fargo, ND 58104-5565, 701-552-6578 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, license 9968 SD) Psychiatry & Neurology, Psychiatry (2084P0800X, license 58770 MN) Psychiatry & Neurology, Psychiatry (2084P0800X, license 4382 IA) Psychiatry & Neurology, Psychiatry (2084P0800X, license 12818 ND) Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, license 58770 MN) Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, license 9968 SD) Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, primary, license 12818 ND) |
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 | |
|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $604K | 50% | $339 | $96 (top 5% from $249) | 98th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $252K | 21% | $202 | $81 (top 5% from $170) | 98th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $182K | 15% | $168 | $67 (top 5% from $174) | 94th percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $117K | 10% | $109 | $49 (top 5% from $101) | 97th percentile | |
| 99238 | Hospital discharge day management, 30 minutes or less | $35K | 3% | $76 | $48 (top 5% from $80) | 93rd percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $18K | 2% | $156 | $112 (top 5% from $313) | 74th percentile |
In this area
4 providers in Cass County, ND carry an indicator in the public record, with $1.5M at stake between them. The most common is part of a provider network, on 3 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | DOYLE'S YELLOW CHECKER CAB, INC Fargo, ND, ranked 55 | $1.5M |
|
| 3 | ELIM HOMES, INC Fargo, ND, ranked 2397 | $0 |
|
| 3 | SISTERS OF MARY OF THE PRESENTATION LONG-TERM CARE Fargo, ND, ranked 3930 | $0 |
|
| 3 | SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE Fargo, ND, ranked 4285 | $0 |
|
Recent enforcement in ND
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.