Providers
HEATHER RENEE DOWNHOUR, MD
NPI 1841398476, individual, Greenfield, IN, Psychiatry & Neurology, Psychiatry
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 35 months, but with up to 1204 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 52 of 100, rank 8292, $10.4M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2019 | More hours than a day holds at a conservative unit price | 26.3 | 50.2 | 33.5 | 32.7 | 863 | 3 | 90791 90832 90834 90853 99213 H0004 H2014 T1016 | $173K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 30.4 | 56.2 | 37.5 | 38.6 | 937 | 4 | 90791 90832 90834 90837 90853 99213 99231 H0004 H2014 T1016 | $174K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 29.1 | 54.3 | 36.2 | 40.3 | 1012 | 3 | 90791 90792 90832 90834 90837 90853 99213 H0004 H2014 T1016 | $181K |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 33.0 | 62.6 | 41.8 | 43.0 | 1034 | 3 | 90791 90792 90832 90834 90853 99213 H0004 H2014 T1016 | $205K |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 29.5 | 56.4 | 37.6 | 38.7 | 978 | 3 | 90791 90792 90832 90834 90837 90853 99213 H0004 H2014 T1016 | $189K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 28.1 | 53.6 | 35.7 | 40.2 | 960 | 3 | 90791 90832 90834 90837 90853 99213 H0004 H0034 H2014 T1016 | $175K |
| Sep 2019 | More hours than a day holds at a conservative unit price | 27.3 | 47.4 | 31.6 | 35.0 | 873 | 3 | 90791 90792 90832 90834 90853 99213 H0004 H2014 T1016 | $150K |
| Oct 2019 | More hours than a day holds at a conservative unit price | 27.8 | 49.7 | 33.1 | 33.5 | 875 | 3 | 90791 90832 90834 90837 90853 99213 H0004 H2014 T1016 | $167K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 29.8 | 52.5 | 35.0 | 36.5 | 938 | 3 | 90791 90792 90832 90834 90853 99213 99214 H0004 H2014 T1016 | $176K |
| Feb 2020 | More hours than a day holds at a conservative unit price | 28.3 | 51.2 | 34.1 | 38.1 | 884 | 3 | 90791 90832 90834 90853 99213 99214 H0004 H2014 T1016 | $161K |
| Apr 2020 | More hours than a day holds at a conservative unit price | 26.6 | 47.7 | 31.8 | 34.3 | 813 | 3 | 90832 90834 90837 90853 99213 99441 H2014 T1016 | $146K |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 28.7 | 50.3 | 33.5 | 36.8 | 829 | 3 | 90832 90834 90837 90853 99213 99214 99441 99442 H0004 H2014 T1016 | $153K |
| Aug 2020 | More hours than a day holds at a conservative unit price | 27.2 | 55.1 | 36.7 | 42.6 | 808 | 3 | 90832 90834 90853 99213 99214 H0004 H2014 T1016 | $179K |
| Sep 2020 | More hours than a day holds at a conservative unit price | 25.9 | 53.1 | 35.4 | 38.5 | 740 | 3 | 90832 90834 90853 99213 99214 H0004 H2014 T1016 | $165K |
| Oct 2020 | More hours than a day holds at a conservative unit price | 25.5 | 50.6 | 33.7 | 39.5 | 876 | 3 | 90791 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $160K |
| Nov 2020 | More hours than a day holds at a conservative unit price | 24.2 | 47.0 | 31.3 | 36.8 | 793 | 3 | 90791 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $140K |
| Dec 2020 | More hours than a day holds at a conservative unit price | 24.9 | 46.0 | 30.7 | 34.4 | 786 | 3 | 90791 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $141K |
| Jan 2021 | More hours than a day holds at a conservative unit price | 25.1 | 46.9 | 31.3 | 39.2 | 829 | 3 | 90791 90832 90834 90853 99213 99214 H0004 H2014 T1016 | $153K |
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 27.8 | 50.2 | 33.5 | 40.9 | 819 | 3 | 90791 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $140K |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 28.1 | 51.1 | 34.1 | 39.9 | 932 | 3 | 90791 90792 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $162K |
| Apr 2021 | More hours than a day holds, even counting one unit per claim line | 29.5 | 53.7 | 35.8 | 41.7 | 921 | 3 | 90791 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $168K |
| May 2021 | More hours than a day holds at a conservative unit price | 25.9 | 48.2 | 32.1 | 39.4 | 864 | 3 | 90791 90832 90834 90837 90853 99214 H0004 H2014 T1016 | $162K |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 31.4 | 57.5 | 38.3 | 44.3 | 940 | 3 | 90791 90792 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $184K |
| Jul 2021 | More hours than a day holds at a conservative unit price | 24.8 | 45.8 | 30.5 | 35.2 | 847 | 3 | 90791 90832 90834 90837 90853 99214 H0004 H2014 T1016 | $157K |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 32.7 | 57.8 | 38.6 | 44.5 | 995 | 3 | 90791 90792 90832 90834 90837 90853 99214 H0004 H2014 T1016 | $200K |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 30.2 | 55.8 | 37.2 | 43.0 | 893 | 3 | 90791 90792 90832 90834 90837 90853 99214 H0004 H2014 T1016 | $178K |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 31.2 | 59.1 | 39.4 | 48.7 | 964 | 3 | 90791 90792 90832 90834 90837 90853 99213 99214 H0004 H2014 T1016 | $200K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 31.3 | 58.8 | 39.2 | 45.5 | 862 | 3 | 90791 90832 90834 90837 90853 99214 H2014 T1016 | $175K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 27.5 | 49.6 | 33.1 | 38.6 | 876 | 3 | 90791 90832 90834 90853 99214 H2014 T1016 | $153K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 32.1 | 60.3 | 40.2 | 51.9 | 991 | 3 | 90791 90832 90834 90837 90853 99213 99214 H2014 T1016 | $181K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 33.0 | 61.9 | 41.3 | 50.6 | 947 | 3 | 90791 90832 90834 90837 90853 99214 H2014 T1016 | $163K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 38.8 | 72.0 | 48.0 | 56.8 | 1204 | 3 | 90791 90792 90832 90834 90837 90853 99213 99214 H2014 T1016 | $215K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 33.0 | 61.2 | 40.8 | 48.7 | 1000 | 3 | 90791 90792 90832 90834 90837 90853 99213 99214 H2014 T1016 | $191K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 31.7 | 59.6 | 39.7 | 47.0 | 924 | 3 | 90791 90832 90834 90837 90853 99214 H2014 T1016 | $189K |
| May 2023 | More hours than a day holds at a conservative unit price | 28.1 | 46.8 | 31.2 | 32.5 | 789 | 3 | 90791 90832 90834 90853 99211 99214 H2014 T1016 | $161K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | HEATHER RENEE DOWNHOUR, MD |
| Type | Individual |
| Status | Active |
| NPI issued | September 20, 2006, last updated November 27, 2023 |
| Practice location | 145 GREEN MEADOWS DRIVE, SUITE 1, Greenfield, IN 46140-4002, 317-462-1481 |
| Mailing address | 6626 E 75TH STREET, SUITE 500, Indianapolis, IN 46250-2890 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 01062361A 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.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H2014 | Skills training and development per 15 minhistory of abuse | $5.0M | 44% | $1K | $298 (top 5% from $3K) | 84th percentile | |
| 90834 | Psychotherapy, 45 minutes | $2.8M | 25% | $128 | $101 (top 5% from $318) | 64th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $933K | 8% | $125 | $60 (top 5% from $332) | 80th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $568K | 5% | $86 | $60 (top 5% from $133) | 75th percentile | |
| 90832 | Psychotherapy, 30 minutes | $395K | 3% | $91 | $59 (top 5% from $239) | 77th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $354K | 3% | $107 | $105 (top 5% from $228) | 52nd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $328K | 3% | $63 | $44 (top 5% from $110) | 75th percentile | |
| H0004 | Behavioral health counseling and therapy per 15 minhistory of abuse | $284K | 2% | $306 | $174 (top 5% from $559) | 81st 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 |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 213 | 68 | $14K | $181 | $94 | 1.9x | 2.3x (90th percentile 3.8x) |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 24 | 23 | $3K | $188 | $142 | 1.3x | 2.4x (90th percentile 4.1x) |
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
2 providers in Hancock County, IN carry an indicator in the public record, with $694K at stake between them. The most common is paid after a public list action, on 1 of them, followed by more hours than a day holds on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | GREEN HOUSE AND ASSOCIATES INC Mccordsville, IN, ranked 258 | $16K |
|
| 4 | KRISTA BRUCKER Greenfield, IN, ranked 9113 | $679K |
|
Recent enforcement in IN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJSentencedJun 18, 2026
Florida Man Sentenced to 36 Months in Prison
As vice president of a dental practice, he submitted claims to Indiana Medicaid falsely billing for hundreds of dental surgeries that were never performed, used patients' personal identifiers without authorization to support the claims, and committed tax evasion to conceal the income.
DOJSentencedFeb 18, 2026
Highland Physician Sentenced to 97 Months in Prison
Cataldi, sole owner of an otolaryngology practice, billed Medicare and private insurance for thousands of balloon sinuplasty procedures that she did not perform, seeking approximately $50 million and being paid almost $20 million.
DOJCivil settlementJan 28, 2026
Settlement for $1.7 Million With Former Physician Don J. Wagoner and His Business Entity for Fraudulently Billing the Indiana Medicaid Program
Defendants required patients seeking opioid or pain medicine prescriptions to give a single urine sample, tested it with one inexpensive multiplexed screening kit, and billed Indiana Medicaid $171.27 or more per patient by falsely certifying that nine or more separate samples had been collected and analyzed.
DOJSentencedJan 8, 2026
Indiana Woman Sentenced to 84 Months in Prison
Reese falsely claimed to be a licensed clinical psychologist, used forged documents to obtain employment and stole the identities and license numbers of three medical professionals to enroll in Indiana Medicaid and bill for therapy services.
DOJSentencedOct 3, 2024
Merrillville Doctor Sentenced to Prison and Ordered to Pay Restitution
Farley submitted claims to Medicaid and Medicare falsely representing that he had complex, extended visits with patients at his addiction treatment practice, billing for more than 7,000 services he did not provide.
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.