HEATHER M SHELTON, M.D.
NPI 1821037631, individual, Terre Haute, IN, Psychiatry & Neurology, Psychiatry
- Hours beyond a day in 41 months, but with up to 1201 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Nov 2018 | More hours than a day holds, even counting one unit per claim line | 26.3 | 31.2 | 20.8 | 25.1 | 618 | 3 | 90791 90832 90834 90837 90846 90847 99212 99213 99214 H2014 T1016 | $71K |
| Dec 2018 | More hours than a day holds, even counting one unit per claim line | 29.0 | 33.7 | 22.5 | 29.6 | 658 | 3 | 90791 90832 90834 90837 90847 99212 99214 H2014 T1016 | $79K |
| Jan 2019 | More hours than a day holds, even counting one unit per claim line | 39.8 | 42.3 | 28.2 | 34.0 | 795 | 3 | 90791 90832 90834 90837 90847 99212 99213 99214 H0004 H2014 T1016 | $111K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 45.0 | 48.5 | 32.3 | 41.0 | 839 | 3 | 90791 90832 90834 90837 90846 90847 99212 99214 H2014 T1016 | $111K |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 43.4 | 45.8 | 30.6 | 41.1 | 906 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99212 99213 99214 H2014 T1016 | $116K |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 44.7 | 44.8 | 29.9 | 37.4 | 912 | 3 | 90791 90792 90832 90834 90837 90847 90853 99212 99214 H0004 H2014 T1016 | $109K |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 41.7 | 39.0 | 26.0 | 31.9 | 887 | 3 | 90791 90832 90834 90837 90847 90853 99212 99214 H2014 T1016 | $98K |
| Jun 2019 | More hours than a day holds, even counting one unit per claim line | 36.7 | 34.4 | 22.9 | 30.9 | 793 | 3 | 90791 90792 90832 90833 90834 90837 90846 90847 90853 99213 99214 H0004 H2014 T1016 | $88K |
| Jul 2019 | More hours than a day holds, even counting one unit per claim line | 32.9 | 33.6 | 22.4 | 27.3 | 755 | 3 | 90791 90792 90832 90833 90834 90837 90847 90853 99212 99213 99214 H0004 H2014 T1016 | $90K |
| Aug 2019 | More hours than a day holds, even counting one unit per claim line | 38.5 | 38.7 | 25.8 | 33.0 | 886 | 3 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 H2014 T1016 | $98K |
| Sep 2019 | More hours than a day holds, even counting one unit per claim line | 38.7 | 39.8 | 26.5 | 35.2 | 899 | 3 | 90791 90792 90832 90834 90837 90847 90853 99212 99213 99214 H2014 T1016 | $95K |
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 40.7 | 39.4 | 26.3 | 32.8 | 906 | 3 | 90791 90792 90832 90834 90837 90839 90847 90853 99213 99214 H2014 T1016 | $97K |
| Nov 2019 | More hours than a day holds, even counting one unit per claim line | 35.4 | 32.5 | 21.7 | 28.2 | 830 | 3 | 90792 90832 90834 90837 90839 90847 90853 99212 99213 99214 H2014 T1016 | $80K |
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 31.9 | 31.4 | 20.9 | 24.9 | 846 | 3 | 90791 90792 90832 90834 90837 90839 90847 90853 99213 99214 H0038 H2014 T1016 | $77K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 42.2 | 41.2 | 27.4 | 30.9 | 1069 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 H0034 H0038 H2014 T1016 | $106K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 41.9 | 40.7 | 27.1 | 32.1 | 1011 | 3 | 90791 90832 90834 90837 90839 90847 90853 99213 99214 H0034 H0038 H2014 T1016 | $98K |
| Mar 2020 | More hours than a day holds, even counting one unit per claim line | 37.6 | 36.6 | 24.4 | 28.0 | 1015 | 3 | 90791 90792 90832 90834 90837 90846 90847 90853 99212 99213 99214 H0038 H2014 T1016 | $96K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 42.4 | 45.7 | 30.5 | 34.5 | 904 | 3 | 90792 90832 90834 90837 90846 90847 90853 99212 99213 99214 H0038 H2014 T1016 | $112K |
| May 2020 | More hours than a day holds, even counting one unit per claim line | 36.3 | 40.6 | 27.1 | 33.0 | 889 | 3 | 90792 90832 90834 90837 90846 90847 90853 99214 H0038 H2014 T1016 | $100K |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 36.9 | 41.8 | 27.9 | 30.5 | 929 | 3 | 90832 90834 90837 90846 90847 90853 99212 99214 H0038 H2014 T1016 | $100K |
| Jul 2020 | More hours than a day holds, even counting one unit per claim line | 38.1 | 42.3 | 28.2 | 30.1 | 946 | 3 | 90791 90832 90834 90837 90846 90847 90853 99212 99213 99214 H0034 H0038 H2014 T1016 | $102K |
| Aug 2020 | More hours than a day holds, even counting one unit per claim line | 37.1 | 44.1 | 29.4 | 34.9 | 1014 | 3 | 90791 90792 90832 90833 90834 90837 90846 90847 90853 99212 99213 99214 H0004 H0034 H0038 H2014 T1016 | $111K |
| Sep 2020 | More hours than a day holds, even counting one unit per claim line | 44.0 | 51.4 | 34.2 | 37.1 | 1015 | 3 | 90791 90792 90832 90833 90834 90837 90846 90847 90853 99213 99214 H0034 H0038 H2014 T1016 | $120K |
| Oct 2020 | More hours than a day holds, even counting one unit per claim line | 41.3 | 48.1 | 32.1 | 35.3 | 1035 | 3 | 90791 90832 90834 90837 90846 90847 90853 99214 H0034 H0038 H2014 T1016 | $119K |
| Nov 2020 | More hours than a day holds, even counting one unit per claim line | 38.8 | 44.6 | 29.7 | 33.5 | 1022 | 3 | 90832 90833 90834 90837 90847 90853 99212 99214 H0034 H0038 H2014 T1016 | $110K |
| Dec 2020 | More hours than a day holds, even counting one unit per claim line | 37.9 | 44.4 | 29.6 | 32.2 | 1059 | 3 | 90791 90832 90833 90834 90837 90847 90853 99212 99213 99214 H0034 H0038 H2014 T1016 | $111K |
| Jan 2021 | More hours than a day holds, even counting one unit per claim line | 38.9 | 43.8 | 29.2 | 35.5 | 1063 | 3 | 90791 90832 90833 90834 90837 90847 90853 99212 99214 H0034 H0038 H2014 T1016 | $114K |
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 41.8 | 48.2 | 32.2 | 37.0 | 1103 | 3 | 90832 90833 90834 90837 90847 90853 99212 99214 H0034 H0038 H2014 T1016 | $114K |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 46.5 | 52.6 | 35.1 | 39.8 | 1201 | 3 | 90792 90832 90833 90834 90837 90847 90853 99212 99213 99214 H0034 H0038 H2014 T1016 | $135K |
| Apr 2021 | More hours than a day holds, even counting one unit per claim line | 44.8 | 47.9 | 31.9 | 37.5 | 1112 | 2 | 90832 90834 90837 90839 90847 90853 99213 99214 H0034 H0038 H2014 T1016 | $116K |
| May 2021 | More hours than a day holds, even counting one unit per claim line | 37.9 | 42.4 | 28.2 | 35.1 | 1092 | 3 | 90791 90832 90833 90834 90837 90847 90853 99212 99214 H0034 H0038 H2014 T1016 | $110K |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 37.3 | 41.3 | 27.5 | 31.3 | 904 | 3 | 90832 90833 90834 90837 90847 90853 99212 99214 H0038 H2014 T1016 | $103K |
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 29.5 | 32.6 | 21.7 | 26.1 | 834 | 3 | 90791 90832 90833 90834 90837 90847 90853 99212 99214 H0038 H2014 T1016 | $86K |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 30.8 | 33.4 | 22.3 | 25.8 | 824 | 2 | 90791 90832 90834 90837 90847 90853 99214 H0038 H2014 T1016 | $87K |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 37.3 | 42.1 | 28.1 | 31.7 | 900 | 2 | 90791 90832 90834 90837 90853 99214 H0034 H0038 H2014 T1016 | $103K |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 32.7 | 40.6 | 27.1 | 33.8 | 924 | 3 | 90791 90832 90834 90837 90853 99212 99214 H0038 H2014 T1016 | $105K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 32.5 | 40.4 | 26.9 | 31.7 | 851 | 3 | 90791 90832 90834 90837 90847 90853 99212 99214 H0038 H2014 T1016 | $100K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 30.8 | 36.7 | 24.5 | 29.9 | 787 | 3 | 90791 90832 90834 90837 90847 90853 99212 99214 H0038 H2014 T1016 | $91K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 29.0 | 35.0 | 23.3 | 27.8 | 737 | 3 | 90791 90832 90834 90837 90847 99212 99214 99215 H0038 H2014 T1016 | $82K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 31.0 | 36.5 | 24.3 | 28.3 | 773 | 3 | 90791 90792 90832 90834 90837 90847 99211 99212 99214 99215 H0038 H2014 | $94K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 27.8 | 33.8 | 22.5 | 27.4 | 738 | 3 | 90791 90792 90832 90834 90837 90847 99212 99214 99215 H0038 H2014 T1016 | $84K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | HEATHER M SHELTON, M.D. (also HEATHER CRUM) |
| Type | Individual |
| Status | Active |
| NPI issued | June 6, 2006, last updated March 13, 2024 |
| Practice location | 500 8TH AVE, Terre Haute, IN 47804-4072, 812-231-8376 |
| Mailing address | 620 8TH AVE, Terre Haute, IN 47804-2771 |
| Specialties | Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, license 01047027A IN) Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 01047027A 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 | 33% | $156 | $191 (top 5% from $442) | 34th percentile | |
| H2014 | Skills training and development per 15 minhistory of abuse | $970K | 16% | $357 | $298 (top 5% from $3K) | 57th percentile | |
| 90834 | Psychotherapy, 45 minutes | $961K | 16% | $88 | $101 (top 5% from $318) | 41st percentile | |
| 90832 | Psychotherapy, 30 minutes | $427K | 7% | $59 | $59 (top 5% from $239) | 51st percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $409K | 7% | $103 | $60 (top 5% from $133) | 87th percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $230K | 4% | $83 | $130 (top 5% from $458) | 21st percentile | |
| T1016 | Case management each 15 min | $160K | 3% | $57 | $98 (top 5% from $507) | 33rd percentile | |
| H0038 | Self-help/peer services per 15 min | $156K | 3% | $65 | $147 (top 5% from $2K) | 31st percentile |
In this area
12 providers in Vigo County, IN carry an indicator in the public record, with $83.4M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by part of a provider network on 3.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | PUTNAM COUNTY HOSPITAL Terre Haute, IN, ranked 5445 | $0 |
|
| 3 | PUTNAM COUNTY HOSPITAL St. Mary Woods, IN, ranked 5492 | $0 |
|
| 3 | PUTNAM COUNTY HOSPITAL Terre Haute, IN, ranked 6880 | $0 |
|
| 4 | DARLA HINSHAW Terre Haute, IN, ranked 7504 | $3.7M |
|
| 4 | SURJIT SINGH Terre Haute, IN, ranked 7635 | $2.4M |
|
| 4 | TYRONE POWELL Terre Haute, IN, ranked 7998 | $29.2M |
|
| 4 | JULIA GADLAGE Terre Haute, IN, ranked 8264 | $18.3M |
|
| 4 | KELLY HUTCHINS Terre Haute, IN, ranked 8340 | $7.0M |
|
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.