BRIAN RUSH SIMPSON, M.D.
NPI 1831206341, individual, Little Rock, AR, Psychiatry & Neurology, Forensic Psychiatry
- Hours beyond a day in 3 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 90833 ($192 per patient-month) sit in the top 5% of every provider billing that code.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 24.7 | 27.5 | 18.4 | 25.0 | 254 | 1 | 90833 99223 99232 99233 99238 | $40K |
| Aug 2019 | More hours than a day holds, even counting one unit per claim line | 26.9 | 28.1 | 18.7 | 26.4 | 285 | 1 | 90833 99223 99232 99233 99238 | $42K |
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 25.3 | 21.0 | 14.0 | 18.9 | 230 | 1 | 90833 99223 99232 99233 99238 | $31K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | BRIAN RUSH SIMPSON, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | August 23, 2006, last updated March 7, 2023 |
| Practice location | 305 S PALM ST, Little Rock, AR 72205-5432, 501-686-9092 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, license E6332 AR) Psychiatry & Neurology, Forensic Psychiatry (2084F0202X, primary, license E6332 AR) |
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 | |
|---|---|---|---|---|---|---|---|
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $939K | 39% | $192 | $49 (top 5% from $109) | 99th percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $707K | 30% | $171 | $96 (top 5% from $249) | 85th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $322K | 13% | $108 | $67 (top 5% from $174) | 81st percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $298K | 12% | $126 | $81 (top 5% from $170) | 84th percentile | |
| 99238 | Hospital discharge day management, 30 minutes or less | $106K | 4% | $45 | $48 (top 5% from $80) | 46th percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $14K | 1% | $89 | $49 (top 5% from $101) | 91st percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $6K | 0% | $148 | $112 (top 5% from $313) | too few months to rank |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 516 | 80 | $24K | $110 | $60 | 1.8x | 2.1x (90th percentile 3.5x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 201 | 63 | $17K | $150 | $108 | 1.4x | 2.6x (90th percentile 4.7x) |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 250 | 64 | $14K | $120 | $72 | 1.7x | 2.6x (90th percentile 4.3x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 61 | 47 | $6K | $275 | $158 | 1.7x | 3.0x (90th percentile 5.6x) |
| 99239 | Hospital discharge day management, more than 30 minutes | 46 | 37 | $4K | $150 | $104 | 1.4x | 2.8x (90th percentile 5.6x) |
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
8 providers in Pulaski County, AR carry an indicator in the public record, with $17.7M at stake between them. The most common is more hours than a day holds, on 6 of them, followed by named in an enforcement record on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | KRAMEELAH BANKS Little Rock, AR, ranked 2462 | $0 |
|
| 3 | ARKANSAS BEHAVIORAL CENTER (ABC), LLC Little Rock, AR, ranked 5190 | $0 |
|
| 4 | CARL RIDDELL Little Rock, AR, ranked 7402 | $7.3M |
|
| 4 | NAVEEN PATIL Little Rock, AR, ranked 7428 | $5.9M |
|
| 4 | LAWRENCE LABBATE Little Rock, AR, ranked 7599 | $2.7M |
|
| 4 | SHANE SPARKS Little Rock, AR, ranked 7948 | $479K |
|
| 4 | NKECHI UGWUH-MOSS Little Rock, AR, ranked 9584 | $81K |
|
| 5 | JOHN DOWNES Little Rock, AR, ranked 10047 | $1.3M |
|
Recent enforcement in AR
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.