Simon, James

Simon, James was paid $1.71M by Medicaid between Mar 2022 and Nov 2023, across 7 billing codes. Its largest line is H0046, Mental health services, not otherwise specified — 30% of everything it billed.

33Billing provider infoSIMON, JAMES
NORTH KINGSTOWN, RI 02852

33aNPI1538477708assigned 09/21/2010

33bProvider typeClinical Social Worker

28Total paid$1.71M

24GClaims27,679

24DCodes billed7

24AFirst – last monthMar 2022 – Nov 2023

Compared with peers

Next to other Clinical Social Worker providers in Rhode Island

Rank by total paid#6 of 358

Median peer was paid$27K

This provider vs. median63×

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.

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
2022	16,968	$974K
2023	10,711	$738K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0046	Mental health services, not otherwise specified	30%	4,047	476	$511K
T1019	Help at home with bathing, dressing and eating, billed per 15 minutesPersonal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)	26%	2,554	225	$443K
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	19%	2,215	326	$318K
T1016	Case management, each 15 minutes	15%	6,122	798	$263K
H2014	Skills training and development, per 15 minutes	5.0%	955	354	$86K
H2016	Community support for mental illness or disability, billed per dayComprehensive community support services, per diem	2.9%	10,938	415	$50K
T1027	Family training and counseling for child development, per 15 minutes	2.4%	848	275	$41K

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.