Providers
All 11 in TX
SHIVA KUMAR LAM, MD
NPI 1871671032, individual, Austin, TX, Psychiatry & Neurology, Psychiatry
5
Evidence tier
informational
- Medicaid dollars per patient on code 99232 ($267 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 10098, $1.1M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SHIVA KUMAR LAM, MD |
| Type | Individual |
| Status | Active |
| NPI issued | November 2, 2006, last updated September 30, 2022 |
| Practice location | 1407 W STASSNEY LN, Austin, TX 78745-2947, 512-440-4800 |
| Mailing address | PO BOX 26100, Austin, TX 78755-0100 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license K4933 TX) |
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 | $696K | 49% | $267 | $67 (top 5% from $174) | 99th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $264K | 19% | $161 | $81 (top 5% from $170) | 94th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $236K | 17% | $103 | $44 (top 5% from $110) | 94th percentile | |
| 99238 | Hospital discharge day management, 30 minutes or less | $214K | 15% | $103 | $48 (top 5% from $80) | 98th percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $11K | 1% | $141 | $112 (top 5% from $313) | 67th percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $2K | 0% | $57 | $96 (top 5% from $249) | 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 | 175 | 33 | $11K | $105 | $77 | 1.4x | 2.6x (90th percentile 4.3x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 18 | 18 | $2K | $223 | $170 | 1.3x | 3.0x (90th percentile 5.6x) |
| 99238 | Hospital discharge day management, 30 minutes or less | 23 | 22 | $1K | $140 | $80 | 1.8x | 2.6x (90th percentile 4.7x) |
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 Travis County, TX carry an indicator in the public record, with $10.3M at stake between them. The most common is part of a provider network, on 5 of them, followed by more hours than a day holds on 5. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | PETER CRAIG Austin, TX, ranked 228 | $25K |
|
| 3 | MGA HEALTHCARE TEXAS, LLC Austin, TX, ranked 896 | $9.8M |
|
| 3 | STATE OF TEXAS VETERANS LAND BOARD Tyler, TX, ranked 2778 | $0 |
|
| 3 | CAPITOL HOME HEALTH, INC. Austin, TX, ranked 5855 | $0 |
|
| 3 | RHI MAGNOLIA OF CENTRAL TEXAS, LLC Pflugerville, TX, ranked 6490 | $0 |
|
| 3 | THREE OAKS HOSPICE AUSTIN LLC Austin, TX, ranked 6865 | $0 |
|
| 4 | THOMAS YANGER Austin, TX, ranked 9520 | $145K |
|
| 4 | JOSE GARCIA Austin, TX, ranked 9716 | $17K |
|
Recent enforcement in TX
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementAug 26, 2026
Dallas medical clinic to pay $7.5 million to resolve COVID-19 testing overbilling allegations
Aymancare billed the federal government's HRSA Uninsured Program for separate evaluation and management services in addition to COVID-19 specimen collection and testing at pop-up testing sites when no such separate services were performed.
DOJConvictedAug 12, 2026
Scammer pharmacist guilty in $20 million healthcare kickback scheme
Thomas paid over $2 million in kickbacks to the owner of a Houston clinic in exchange for referrals of DOL-OWCP insured patients prescribed high-reimbursement compounded medications, which his pharmacy then billed to DOL-OWCP, receiving more than $20 million in reimbursements.
DOJIndictedJun 24, 2026
U.S. Attorney Announces Major Health Care Fraud Cases in Western District of Texas
Charles is alleged to have received illegal kickbacks for referring patients to San Antonio area hospice companies, causing over $9 million in Medicare claims, while Dr. Duncan settled allegations of billing Medicare and TRICARE for an unapproved amniotic-based product and Trevor's Place settled allegations of submitting inflated TRICARE claims for services not provided.
DOJIndictedJun 23, 2026
Nine charged in SDTX as part of national health care fraud takedown
Nine defendants were indicted in the Southern District of Texas for operating pill mill clinics and a pharmacy that unlawfully distributed controlled substances, billing Medicaid $16 million for mental health services for minors that did not occur, and billing Medicare and TRICARE approximately $906 million for medically unnecessary amniotic wound allografts procured through kickbacks.
DOJChargedJun 23, 2026
Northern District of Texas Charges 13 Health Care Fraudsters for Loss Over $360 Million
Thirteen defendants in the Northern District of Texas were charged in seven cases involving more than $365 million in fraudulent billing to federally-funded programs and other insurers, including laboratory and genetic testing claims procured through kickbacks, transcranial magnetic stimulation treatments billed to TRICARE, medically unnecessary EEG testing, and hospice services never provided.
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.