Behavioral
Community Medical Associates, INC.
Community Medical Associates, INC. was paid $808K by Medicaid between Jan 2018 and Nov 2024, across 43 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 38% of everything it billed.
33Billing provider infoCOMMUNITY MEDICAL ASSOCIATES, INC.
LOUISVILLE, KY 40241
LOUISVILLE, KY 40241
33aNPI1437382074assigned 08/31/2009
33bProvider typeClinical Neuropsychologist
28Total paid$808K
24GClaims46,964
24DCodes billed43
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Clinical Neuropsychologist providers in Kentucky
Rank by total paid#3 of 8
Median peer was paid$49K
This provider vs. median16×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official GAST, SHELLEY controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,209 | $20K | |
| 2019 | 5,011 | $55K | |
| 2020 | 3,916 | $49K | |
| 2021 | 6,906 | $130K | |
| 2022 | 8,174 | $145K | |
| 2023 | 11,276 | $204K | |
| 2024incomplete | 9,472 | $204K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 38% | 8,237 | 6,959 | $311K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 13% | 3,977 | 3,568 | $108K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 13% | 24,383 | 19,500 | $101K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 5.7% | 1,128 | 827 | $46K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 5.2% | 576 | 482 | $42K |
| 99223 | Prolong inpt eval add15 m | 4.0% | 608 | 457 | $32K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 3.9% | 475 | 423 | $32K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 2.5% | 388 | 313 | $21K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 2.5% | 959 | 437 | $20K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 1.5% | 760 | 291 | $12K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.4% | 577 | 512 | $12K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 1.2% | 134 | 87 | $10K |
31 more codes
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 113 | $7K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 136 | $6K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 183 | $6K |
| 99460 | <1% | 94 | $6K | |
| 96111 | <1% | 50 | $5K | |
| 99480 | Subsequent intensive care, per day, low birth weight infant | <1% | 60 | $5K |
| 93000 | <1% | 983 | $4K | |
| 93793 | <1% | 1,056 | $4K | |
| 72110 | <1% | 123 | $4K | |
| 99462 | <1% | 59 | $2K | |
| 93296 | <1% | 400 | $2K | |
| 93018 | <1% | 237 | $2K | |
| 99205 | Prolong outpt/office vis | <1% | 18 | $1K |
| 72170 | <1% | 44 | $712.59 | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 73 | $625.82 |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 13 | $542.80 |
| 72050 | <1% | 14 | $528.47 | |
| 99152 | <1% | 42 | $508.28 | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 17 | $479.42 |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 21 | $474.77 |
| 36415 | Collection of venous blood by venipuncture | <1% | 196 | $453.66 |
| 85610 | <1% | 204 | $394.90 | |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 21 | $325.64 |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 21 | $278.43 |
| 72100 | <1% | 86 | $278.33 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 322 | $15.70 |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 0% | 28 | $0.00 |
| 76819 | Fetal biophysical profile; without non-stress testing | 0% | 35 | $0.00 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 0% | 19 | $0.00 |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 0% | 60 | $0.00 |
| 81003 | 0% | 34 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGAST, SHELLEY (VP MANAGED CARE)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.