CATHERINE STEWART ALLEN, LMFT
NPI 1144387028, individual, Providence, RI, Counselor, Mental Health
- Hours beyond a day in 27 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code H0036 ($1632 per patient-month) sit in the top 5% of every provider billing that code.
- 99% of Medicaid dollars are on codes with a history of abuse.
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 2018 | More hours than a day holds at a conservative unit price | 14.3 | 200.9 | 133.9 | 88.4 | 342 | 1 | 90791 H0004 H0036 H2014 | $333K |
| Feb 2018 | More hours than a day holds at a conservative unit price | 10.1 | 160.7 | 107.1 | 46.6 | 303 | 1 | 90791 H0004 H0036 H2014 | $210K |
| Mar 2018 | More hours than a day holds at a conservative unit price | 15.1 | 217.9 | 145.3 | 91.8 | 356 | 1 | 90791 H0004 H0036 H2014 | $349K |
| Apr 2018 | More hours than a day holds at a conservative unit price | 15.0 | 219.1 | 146.1 | 101.0 | 353 | 1 | 90791 H0004 H0036 H2014 | $343K |
| May 2018 | More hours than a day holds at a conservative unit price | 14.7 | 221.1 | 147.4 | 87.1 | 347 | 1 | 90791 H0004 H0036 H2014 | $351K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 13.2 | 184.4 | 122.9 | 84.0 | 299 | 1 | 90791 H0004 H0036 H2014 | $298K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 14.3 | 195.0 | 130.0 | 94.9 | 342 | 1 | 90791 H0004 H0036 H2014 | $331K |
| Aug 2018 | More hours than a day holds at a conservative unit price | 16.6 | 221.1 | 147.4 | 114.0 | 357 | 1 | 90791 H0004 H0036 H2014 | $392K |
| Sep 2018 | More hours than a day holds at a conservative unit price | 15.7 | 231.4 | 154.3 | 103.8 | 347 | 1 | 90791 H0004 H0036 H2014 | $364K |
| Oct 2018 | More hours than a day holds at a conservative unit price | 18.4 | 267.2 | 178.1 | 110.6 | 354 | 1 | 90791 H0004 H0036 H2014 | $435K |
| Nov 2018 | More hours than a day holds at a conservative unit price | 12.2 | 174.5 | 116.4 | 79.1 | 317 | 1 | 90791 H0004 H0036 H2014 | $283K |
| Jan 2019 | More hours than a day holds at a conservative unit price | 3.7 | 53.3 | 35.5 | 44.0 | 111 | 1 | H0004 H0036 H2014 | $92K |
| Feb 2019 | More hours than a day holds at a conservative unit price | 5.3 | 61.6 | 41.0 | 49.9 | 123 | 1 | 90791 H0004 H2014 | $112K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 5.4 | 64.1 | 42.8 | 55.3 | 138 | 1 | 90791 H0004 H2014 | $128K |
| Apr 2019 | More hours than a day holds at a conservative unit price | 8.6 | 94.3 | 62.9 | 70.4 | 155 | 1 | 90791 H0004 H2014 | $198K |
| May 2019 | More hours than a day holds at a conservative unit price | 7.1 | 90.4 | 60.2 | 70.5 | 113 | 1 | H0004 H2014 | $180K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 5.0 | 65.4 | 43.6 | 58.1 | 118 | 1 | 90791 H0004 H2014 | $123K |
| Jul 2019 | More hours than a day holds at a conservative unit price | 4.3 | 61.0 | 40.7 | 48.8 | 102 | 1 | H0004 H2014 | $117K |
| Aug 2019 | More hours than a day holds at a conservative unit price | 4.2 | 56.2 | 37.5 | 46.1 | 95 | 1 | H0004 H2014 | $111K |
| Sep 2019 | More hours than a day holds at a conservative unit price | 5.1 | 57.2 | 38.1 | 46.9 | 113 | 1 | 90791 H0004 H2014 | $113K |
| Oct 2019 | More hours than a day holds at a conservative unit price | 5.5 | 58.7 | 39.1 | 45.3 | 127 | 1 | 90791 H0004 H2014 | $120K |
| Nov 2019 | More hours than a day holds at a conservative unit price | 4.2 | 51.5 | 34.3 | 43.5 | 105 | 1 | H0004 H2014 | $96K |
| Dec 2019 | More hours than a day holds at a conservative unit price | 18.4 | 217.0 | 144.7 | 180.9 | 385 | 1 | 90791 H0004 H2014 | $422K |
| Jan 2020 | More hours than a day holds at a conservative unit price | 28.3 | 328.3 | 218.9 | 242.3 | 412 | 1 | 90791 H0004 H2014 | $580K |
| Feb 2020 | More hours than a day holds at a conservative unit price | 25.6 | 297.8 | 198.5 | 237.0 | 373 | 1 | 90791 H0004 H2014 | $492K |
| Mar 2020 | More hours than a day holds at a conservative unit price | 31.2 | 243.6 | 162.4 | 195.3 | 353 | 1 | 90791 H0004 H2014 | $419K |
| Apr 2020 | More hours than a day holds at a conservative unit price | 30.5 | 154.5 | 103.0 | 122.2 | 358 | 1 | 90791 H0004 H2014 | $258K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CATHERINE STEWART ALLEN, LMFT |
| Type | Individual |
| Status | Active |
| NPI issued | January 2, 2007, last updated March 19, 2012 |
| Practice location | 765 ALLENS AVE, SUITE 102, Providence, RI 02905-5443, 401-490-8918 |
| Mailing address | 2403 POST RD, Wakefield, RI 02879-7547 |
| Specialties | Counselor, Mental Health (101YM0800X, primary, license MFT00076 RI) |
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.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H0004 | Behavioral health counseling and therapy per 15 minhistory of abuse | $4.7M | 58% | $1K | $174 (top 5% from $559) | 98th percentile | |
| H2014 | Skills training and development per 15 minhistory of abuse | $2.0M | 25% | $758 | $298 (top 5% from $3K) | 78th percentile | |
| H0036 | Community psychiatric supportive treatment face-to-face per 15 minhistory of abuse | $1.2M | 15% | $2K | $195 (top 5% from $1K) | 99th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $105K | 1% | $133 | $105 (top 5% from $228) | 75th percentile |
In this area
15 providers in Providence County, RI carry an indicator in the public record, with $22.4M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by part of a provider network on 6. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | CARE CENTER RHODE ISLAND LLC East Providence, RI, ranked 100 | $270K |
|
| 3 | BEACON HOSPICE, LLC East Providence, RI, ranked 989 | $1.7M |
|
| 3 | CORTLAND PLACE REHAB CENTER LLC Greenville, RI, ranked 1385 | $75K |
|
| 3 | OVERLOOK EDEN OPERATIONS, LLC Pascoag, RI, ranked 3154 | $0 |
|
| 3 | VIOLET SNF HOLDCO LLC Pawtucket, RI, ranked 4230 | $0 |
|
| 3 | CL OPERATING LLC Pascoag, RI, ranked 4389 | $0 |
|
| 3 | FRIENDLY EDEN OPERATIONS LLC Woonsocket, RI, ranked 7098 | $0 |
|
| 4 | PAULO PINA Providence, RI, ranked 7365 | $12.0M |
|
Recent enforcement in RI
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
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.