Providers
All 11 in MN
DAVID T BALDES, MD
NPI 1821223025, individual, Duluth, MN, Psychiatry & Neurology, Psychiatry
5
Evidence tier
informational
- Medicaid dollars per patient on code 99233 ($310 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 10253, $524K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DAVID T BALDES, MD |
| Type | Individual |
| Status | Active |
| NPI issued | May 18, 2009, last updated April 24, 2014 |
| Practice location | 220 N 6TH AVE E, Duluth, MN 55805-1952, 218-249-7000 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 53778 MN) |
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 | |
|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $358K | 52% | $310 | $96 (top 5% from $249) | 98th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $135K | 19% | $194 | $67 (top 5% from $174) | 96th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $100K | 14% | $153 | $81 (top 5% from $170) | 93rd percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $63K | 9% | $94 | $49 (top 5% from $101) | 92nd percentile | |
| G0463 | Medicaid service code | $37K | 5% | $36 | $73 (top 5% from $142) | 26th percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $253 | 0% | $17 | $112 (top 5% from $313) | too few months to rank | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $0 | 0% | $0.00 | $49 (top 5% from $109) | too few months to rank |
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 |
|---|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 303 | 56 | $27K | $453 | $112 | 4.1x | 2.6x (90th percentile 4.7x) |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 161 | 49 | $9K | $309 | $74 | 4.2x | 2.6x (90th percentile 4.3x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 39 | 37 | $5K | $821 | $163 | 5.0x | 3.0x (90th percentile 5.6x) |
| 99239 | Hospital discharge day management, more than 30 minutes | 43 | 37 | $4K | $445 | $109 | 4.1x | 2.8x (90th percentile 5.6x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 41 | 15 | $2K | $208 | $61 | 3.4x | 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
11 providers in St. Louis County, MN carry an indicator in the public record, with $10.0M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by part of a provider network on 4.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | RANGE REGIONAL HEALTH SERVICES Hibbing, MN, ranked 1438 | $42K |
|
| 3 | SPECTRUM COMMUNITY HEALTH INC Virginia, MN, ranked 5111 | $0 |
|
| 3 | JENSEN HEALTH LLC Duluth, MN, ranked 6413 | $0 |
|
| 3 | RANGE REGIONAL HEALTH SERVICES Hibbing, MN, ranked 7048 | $0 |
|
| 5 | MICHAEL MEYER Duluth, MN, ranked 10204 | $645K |
|
| 5 | MITCHELL HOLT Duluth, MN, ranked 10336 | $345K |
|
| 5 | JESSICA JACOBSON Duluth, MN, ranked 10681 | $6.7M | |
| 5 | DAWN PETERSON Duluth, MN, ranked 10923 | $1.4M |
Recent enforcement in MN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJOtherMay 22, 2026
This Week in Fraud: The Fraud Division Announced Expansion of Midwest Task Force and Authorization to Hire 15 New Medicaid Prosecutors, an Unprecedented Minnesota Health Care Fraud Takedown, and a $2 Billion Telemedicine Health Care Fraud Scheme
The Justice Department announced charges against 15 defendants for Medicaid fraud schemes totaling over $90 million in intended loss, a 10-year sentence in a $2 billion international health care fraud conspiracy in Brooklyn, and a Michigan jury conviction of a nurse who bribed a Detroit hospital nurse for confidential records used to bill Medicare in a $1.6 million scheme, along with expansion of the Health Care Fraud Midwest Strike Force and hiring of 15 additional Medicaid fraud prosecutors.
DOJChargedMay 21, 2026
Minnesota Health Care Fraud Takedown Results in Charges Against 15 Defendants for Over $90M in Fraud
Fifteen defendants were charged in connection with schemes involving over $90 million in intended loss against Minnesota Medicaid programs, including paying kickbacks to parents and billing for autism, Integrated Community Supports, Individualized Home Supports, Housing Stabilization Services and child care services that were not provided as represented.
DOJPleaded guiltyFeb 10, 2026
Fraud Tourists Plead Guilty to Minneapolis Medicaid Fraud
Two men set up businesses in Minneapolis, enrolled as Housing Stabilization Services providers, recruited Medicaid beneficiaries at homeless shelters and Section 8 housing, billed for services not provided, and used ChatGPT and fabricated e-mails to create fake client records when asked for documentation.
DOJChargedSep 24, 2025
First Defendant Charged in Autism Fraud Scheme
Hassan and others enrolled Smart Therapy LLC as an EIDBI autism services provider, recruited children with cash kickbacks to parents, employed unqualified behavioral technicians, and submitted inflated and fabricated Medicaid claims for services not provided, obtaining more than $14 million, while also submitting approximately $465,000 in fraudulent Federal Child Nutrition Program claims through Feeding Our Future.
DOJCivil settlementJun 26, 2025
NUWAY Alliance Agrees to Pay $18,500,000 Settlement in Medicaid Kickbacks Scheme, False Claims Act Violations
NUWAY compensated Medicaid patients for seeking intensive outpatient treatment in violation of the federal anti-kickback statute and submitted false claims for IOP services not provided by double-billing the same period of time as distinct billable units.
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.