YUANHUI ZHANG, MD

NPI 1841305257, individual, Princeton, WV, Physical Medicine & Rehabilitation

Evidence tier

structure or single-organization volume

Hours beyond a day in 1 month under one organization, which can be supervisory billing.
Records needed.
Medicaid dollars per patient on code 99232 ($331 per patient-month) sit in the top 5% of every provider billing that code.

score 54 of 100, rank 8063, $114K 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
Feb 2018	More hours than a day holds at a conservative unit price	5.3	40.4	26.9	37.7	92	1	99223 99231 99232 99233 99239	$25K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	YUANHUI ZHANG, MD
Type	Individual, sole proprietor
Status	Active
NPI issued	August 19, 2006, last updated December 7, 2014
Practice location	225 KENSINGTON CT, Princeton, WV 24740-4260, 312-513-5339
Specialties	Physical Medicine & Rehabilitation (208100000X, license 36772 IA) Physical Medicine & Rehabilitation (208100000X, license P6304 TX) Physical Medicine & Rehabilitation (208100000X, license ME107968 FL) Physical Medicine & Rehabilitation (208100000X, license MD160013 OR) Physical Medicine & Rehabilitation (208100000X, primary, license 25999 WV)

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
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	$83K	57%	$331	$67 (top 5% from $174)	100th percentile
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	$42K	29%	$150	$96 (top 5% from $249)	78th percentile
99239	Hospital discharge day management, more than 30 minutes	$9K	6%	$65	$49 (top 5% from $101)	71st percentile
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	$8K	6%	$80	$81 (top 5% from $170)	49th percentile
99231	Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	$3K	2%	$98	$37 (top 5% from $103)	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
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	2,243	291	$134K	$250	$75	3.3x	2.6x (90th percentile 4.3x)
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	1,173	296	$105K	$400	$113	3.6x	2.6x (90th percentile 4.7x)
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	341	298	$45K	$500	$164	3.0x	3.0x (90th percentile 5.6x)
99239	Hospital discharge day management, more than 30 minutes	329	289	$28K	$400	$108	3.7x	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

3 providers in Mercer County, WV carry an indicator in the public record, with $1.5M at stake between them. The most common is part of a provider network, on 2 of them, followed by more hours than a day holds on 1.

tier	provider	at stake	why
3	AMEDISYS WEST VIRGINIA, L.L.C. Bluefield, WV, ranked 3277	$0	Part of provider network D1-00071, ranked 71 nationally.
3	AMEDISYS HOSPICE, L.L.C. Bluefield, WV, ranked 7228	$0	Part of provider network D1-00071, ranked 71 nationally.
5	BYRON SMITH Princeton, WV, ranked 10899	$1.5M

Recent enforcement in WV

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementJun 23, 2026

Northern District of West Virginia Part of National Health Care Fraud Takedown Resulting in 455 Defendants Charged in Connection with Over $6.5 Billion in Alleged Fraud

Two providers reached civil settlements resolving allegations that they used pre-signed, invalid prescriptions issued outside the usual course of their professional practice to patients in West Virginia while traveling and not in close proximity to their offices, and in one case submitted claims to Medicare and Medicaid during that time.

DOJComplaint filedJun 23, 2026

U.S. Attorney Moore Capito Announces Fraud Conspiracy Charges Against Sober Living Home Founder and Spouse

Two individuals affiliated with a sober living recovery program allegedly conspired to falsify and submit timesheets to a testing laboratory for drug testing work not performed, and the laboratory paid the billings and obtained reimbursement from federal and state healthcare programs; separately, a sleep laboratory paid $120,000 to resolve allegations it billed Medicaid and the VA Community Health program for sleep studies and polysomnogram reports prepared and signed by unqualified, non-physician staff.

DOJPleaded guiltyJun 17, 2026

Mercer County Woman Pleads Guilty to $175,731.31 Fraud Scheme Targeting Federal Veterans Health Care Benefits

Radford, an owner of Healthcare Therapy Services LLC doing business as Medical Massage Therapy, submitted false bills to CHAMPVA for massage services not rendered, stealing $175,731.31.

DOJCivil settlementMar 5, 2026

Laboratory Agrees to Pay More than $200,000 for Improper Billing to West Virginia Medicaid Program

Integra repeatedly submitted billings to the West Virginia Medicaid program for medically unnecessary testing ordered by medical providers over a two-year period, specifically improper claims for specimen validity testing that were not allowable.

DOJCivil settlementApr 2, 2025

Beckley Medical Clinic and Physician Agree to Pay $152,382.70 to Resolve False Claims Act Allegations

Med-Surg and its owner submitted claims to Medicare and Medicaid using HCPCS code Q3014 for the telehealth originating site facility fee for telehealth visits where the patient was at home, which is not payable.

Referral packet

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