Providers

JUSTINE SIMPSON, Ed.D, LPCC-S

NPI 1871866046, individual, Lancaster, OH, Counselor, Mental Health

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 1 month, but with up to 374 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 51 of 100, rank 9275, $407K 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Apr 2019More hours than a day holds, even counting one unit per claim line28.725.717.122.8374190791 90832 90834 90837 90847 H2011$59K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameJUSTINE SIMPSON, Ed.D, LPCC-S
TypeIndividual
StatusActive
NPI issuedFebruary 17, 2012, last updated May 20, 2026
Practice location2652 KULL RD, Lancaster, OH 43130-7707, 614-815-2300
Specialties
Counselor, Mental Health (101YM0800X, primary, license E.1901488-SUPV OH)

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
codewhat it ispaidshareper patient-monthtypicalrank among providers
90837Psychotherapy, 1 hourhistory of abuse$389K44%$222$191 (top 5% from $442)62nd percentile
90847Family psychotherapy with patient, 50 minutes$176K20%$160$130 (top 5% from $458)64th percentile
90887Medicaid service code$119K14%$140$98 (top 5% from $270)72nd percentile
90834Psychotherapy, 45 minutes$87K10%$107$101 (top 5% from $318)54th percentile
H2011Crisis intervention service per 15 min$63K7%$141$181 (top 5% from $3K)44th percentile
90832Psychotherapy, 30 minutes$33K4%$75$59 (top 5% from $239)66th percentile
90791Psychiatric diagnostic evaluation$14K2%$115$105 (top 5% from $228)62nd percentile
H0036Community psychiatric supportive treatment face-to-face per 15 minhistory of abuse$4100%$32$195 (top 5% from $1K)too few months to rank

In this area

4 providers in Fairfield County, OH carry an indicator in the public record, with $4.3M 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 2.

tierproviderat stakewhy
3ANTIMA HOME HEALTH CARE LLC
Pickerington, OH, ranked 3182
$0
  • Part of provider network D1-00141, ranked 141 nationally.
3CV OPERATING LLC
Lancaster, OH, ranked 6755
$0
  • Part of provider network D1-00083, ranked 83 nationally.
4STEVEN COX
Lancaster, OH, ranked 7726
$1.7M
  • Hours beyond a day in 13 months, but with up to 1322 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
5JAMES GUENTHER
Lancaster, OH, ranked 9931
$2.7M
  • Medicaid dollars per patient on code 99204 ($186 per patient-month) sit in the top 5% of every provider billing that code.

Recent enforcement in OH

All releases

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

DOJCivil settlementJun 23, 2026
Ohio Dentist Agrees to Pay $500,000 to Resolve Allegations of Submitting False Claims to Medicaid
Meckler billed the Ohio Department of Medicaid for services provided by Ball, who was excluded from the Medicaid program, by listing Meckler as the rendering provider instead of Ball.
DOJSentencedJun 15, 2026
Ohio Doctor Ordered to Pay Nearly $1M for Facilitating Fraud on Medicare
A physician working as an independent contractor for a telemedicine company signed doctor's orders for durable medical equipment braces and genetic testing without meaningfully reviewing patient records or performing required in-person assessments, and those orders were used to bill Medicare more than $1,842,524.
DOJCivil settlementApr 2, 2026
Trinity Hospital Agrees to Pay $1.7M to Resolve Alleged Stark Law Violations
Trinity agreed to pay $1.7 million to resolve allegations that from 2014 through 2020 it made improper financial contributions to two referring physicians through office space rental arrangements that exceeded fair market value, in violation of the Stark Law.
DOJComplaint filedFeb 20, 2026
Justice Department Sues OhioHealth for Anticompetitive Healthcare Contracts That Increase Costs for Ohio Patients
The Justice Department and Ohio Attorney General filed a civil antitrust complaint alleging OhioHealth used its market power to impose contractual restrictions that prevent insurers from offering lower-cost health plans and limit access to price information.
DOJSentencedJan 14, 2026
Ohio Doctor Sentenced to Prison for $14M Healthcare Fraud Scheme
A licensed Ohio physician employed by two Florida telemedicine companies signed pre-completed orders for durable medical equipment and cancer genetic testing, falsely affirming he had examined the patients, causing more than $14.5 million in fraudulent Medicare claims.

Referral packet

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