Providers
GUY LERNER, MD
NPI 1770671547, individual, Elizabethtown, KY, Anesthesiology, Addiction Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 29 months, but with up to 1687 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 51 of 100, rank 8563, $3.0M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 24.3 | 20.0 | 13.3 | 18.8 | 1142 | 1 | 90833 90836 90838 99204 99213 99214 99406 | $50K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 25.5 | 25.7 | 17.2 | 23.4 | 1118 | 1 | 90832 90833 90834 90836 90837 90838 99204 99212 99213 99214 99406 | $61K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 30.1 | 28.5 | 19.0 | 28.0 | 1335 | 1 | 90832 90833 90836 90838 97151 99204 99213 99214 99406 | $70K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 31.7 | 32.5 | 21.7 | 30.4 | 1449 | 1 | 90833 90836 90837 90838 99204 99213 99214 99406 | $70K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 30.8 | 31.8 | 21.2 | 28.6 | 1529 | 1 | 90791 90832 90833 90836 90838 99204 99213 99214 99406 | $76K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 30.6 | 32.0 | 21.3 | 30.5 | 1536 | 1 | 90791 90833 90836 90837 90838 97151 99204 99213 99214 99406 | $74K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 30.5 | 33.6 | 22.4 | 31.6 | 1620 | 1 | 90791 90832 90833 90836 90838 97151 99204 99213 99214 99215 99406 | $82K |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 30.2 | 34.2 | 22.8 | 31.1 | 1576 | 1 | 90791 90832 90833 90836 90838 97151 99204 99213 99214 99215 99406 | $81K |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 28.3 | 30.3 | 20.2 | 29.8 | 1533 | 1 | 90791 90832 90833 90836 90838 97151 99204 99213 99214 99406 | $73K |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 33.8 | 38.6 | 25.7 | 34.7 | 1687 | 1 | 90791 90832 90833 90836 90838 97151 99204 99213 99214 99406 | $91K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 34.5 | 38.4 | 25.6 | 34.9 | 1626 | 1 | 90832 90833 90836 90838 99204 99213 99214 99215 99406 | $86K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 32.0 | 38.0 | 25.3 | 37.4 | 1607 | 1 | 90832 90833 90836 90838 99204 99213 99214 99215 99406 | $86K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 29.8 | 35.5 | 23.7 | 32.3 | 1408 | 1 | 90833 90836 90838 99204 99213 99214 99406 | $80K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 30.8 | 37.3 | 24.9 | 35.1 | 1490 | 1 | 90832 90833 90836 90838 99204 99213 99214 99406 | $93K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 24.9 | 29.7 | 19.8 | 27.7 | 1178 | 1 | 90832 90833 90836 90838 99204 99213 99214 | $67K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 26.8 | 31.8 | 21.2 | 28.6 | 1266 | 1 | 90832 90833 90836 90838 99204 99213 99214 | $78K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 25.3 | 30.5 | 20.3 | 30.5 | 1222 | 1 | 90832 90833 90836 90837 90838 99204 99213 99214 99215 | $74K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 28.8 | 34.4 | 23.0 | 30.9 | 1313 | 1 | 90832 90833 90836 90838 99204 99213 99214 99215 | $85K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 29.8 | 36.8 | 24.5 | 33.4 | 1433 | 1 | 90832 90833 90836 90838 99204 99213 99214 99215 | $87K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 38.2 | 28.4 | 18.9 | 28.0 | 1264 | 1 | 90833 90836 90838 99204 99213 99214 99215 | $68K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 39.2 | 29.6 | 19.7 | 26.6 | 1300 | 1 | 90832 90833 90836 90838 99204 99213 99214 99215 | $73K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 24.8 | 27.7 | 18.5 | 26.4 | 1269 | 1 | 90832 90833 90836 90838 99204 99213 99214 | $67K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 28.2 | 30.6 | 20.4 | 28.7 | 1388 | 1 | 90832 90833 90836 90838 99204 99213 99214 99215 | $78K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 29.8 | 36.4 | 24.3 | 32.7 | 1537 | 1 | 90832 90833 90836 90837 90838 99204 99205 99213 99214 99215 | $96K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 29.8 | 35.6 | 23.7 | 32.7 | 1478 | 1 | 90832 90833 90836 90837 90838 99204 99213 99214 99215 | $87K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 24.3 | 29.7 | 19.8 | 29.2 | 1304 | 1 | 90832 90833 90836 90837 90838 99204 99205 99213 99214 99215 | $79K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 26.4 | 27.0 | 18.0 | 25.3 | 1216 | 1 | 90832 90833 90836 90838 99204 99205 99212 99213 99214 | $71K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 25.0 | 31.9 | 21.3 | 30.4 | 1260 | 1 | 90833 90836 90838 99204 99205 99212 99213 99214 99215 | $80K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 29.0 | 36.4 | 24.3 | 32.7 | 1409 | 1 | 90833 90836 90838 99204 99205 99212 99213 99214 99215 | $96K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | GUY LERNER, MD |
| Type | Individual |
| Status | Active |
| NPI issued | October 10, 2006, last updated February 13, 2025 |
| Practice location | 110 CHASE WAY STE 2, Elizabethtown, KY 42701-7827, 502-212-0071 |
| Mailing address | 11300 MAPLE BROOK DR, Louisville, KY 40241-2080 |
| Specialties | Counselor, Addiction (Substance Use Disorder) (101YA0400X, license 34741 KY) Anesthesiology (207L00000X, license 34741 KY) Preventive Medicine, Addiction Medicine (2083A0300X, license 611539 KY) Pain Medicine, Interventional Pain Medicine (208VP0014X, license 34741 KY) Anesthesiology, Addiction Medicine (207LA0401X, primary, license 611539 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
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H0020 | Medicaid service code | $16.2M | 63% | $404 | $214 (top 5% from $529) | 83rd percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $3.0M | 12% | $66 | $45 (top 5% from $110) | 76th percentile | |
| T2023 | Medicaid service code | $1.5M | 6% | $362 | $332 (top 5% from $1K) | 66th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.4M | 5% | $66 | $60 (top 5% from $133) | 57th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.3M | 5% | $43 | $44 (top 5% from $110) | 48th percentile | |
| H0047 | Medicaid service code | $683K | 3% | $432 | $300 (top 5% from $6K) | 58th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $462K | 2% | $96 | $95 (top 5% from $171) | 51st percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $399K | 2% | $44 | $49 (top 5% from $109) | 44th 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 |
|---|---|---|---|---|---|---|---|---|
| 80307 | Testing for presence of drug, by chemistry analyzers | 101 | 28 | $6K | $250 | $58 | 4.3x | 3.2x (90th percentile 7.6x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 82 | 23 | $5K | $108 | $81 | 1.3x | 2.2x (90th percentile 3.8x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 35 | 17 | $3K | $180 | $109 | 1.6x | 2.3x (90th percentile 3.8x) |
| 90838 | Psychotherapy with evaluation and management visit, 1 hour | 17 | 12 | $2K | $240 | $114 | 2.1x | 1.8x (90th percentile 3.1x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 19 | 12 | $980 | $150 | $68 | 2.2x | 2.1x (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
6 providers in Hardin County, KY carry an indicator in the public record, with $11.0M at stake between them. The most common is part of a provider network, on 3 of them, followed by more hours than a day holds on 2. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | RECOVERY CENTER OF KENTUCKY, LLC Elizabethtown, KY, ranked 41 | $4.5M |
|
| 3 | COMMONWEALTH OF KENTUCKY Radcliff, KY, ranked 4168 | $0 |
|
| 3 | BAPTIST HEALTHCARE SYSTEM INC Elizabethtown, KY, ranked 5722 | $0 |
|
| 3 | HARDIN KY OPCO LLC Elizabethtown, KY, ranked 5832 | $0 |
|
| 5 | JAMES DUKE Elizabethtown, KY, ranked 9880 | $6.4M |
|
| 5 | DIANNE BRADLEY Elizabethtown, KY, ranked 11644 | $92K |
Recent enforcement in KY
All releasesDepartment 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
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.