JACQUELINE MACHAMER, LCSW
NPI 1528615366, individual, Mchenry, IL, Social Worker, Clinical
- Hours beyond a day in 5 months under one organization, which can be supervisory billing.
- Records needed.
- 94% 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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 27.0 | 25.0 | 16.6 | 23.0 | 269 | 1 | 90791 90837 90847 | $82K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 37.0 | 38.9 | 26.0 | 35.4 | 281 | 1 | 90791 90834 90837 90847 | $133K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 34.0 | 35.8 | 23.9 | 32.2 | 271 | 1 | 90791 90834 90837 | $127K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 33.6 | 35.5 | 23.7 | 35.5 | 271 | 1 | 90791 90834 90837 | $122K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 27.9 | 29.2 | 19.5 | 26.2 | 260 | 1 | 90791 90834 90837 | $104K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JACQUELINE MACHAMER, LCSW |
| Type | Individual |
| Status | Active |
| NPI issued | August 26, 2019, last updated April 21, 2023 |
| Practice location | 4209 W SHAMROCK LN UNIT C, Mchenry, IL 60050-8700, 224-595-0835 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license 149.024753 IL) |
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 | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $1.1M | 94% | $378 | $191 (top 5% from $442) | 92nd percentile | |
| 90791 | Psychiatric diagnostic evaluation | $33K | 3% | $132 | $105 (top 5% from $228) | 74th percentile | |
| 90834 | Psychotherapy, 45 minutes | $25K | 2% | $138 | $101 (top 5% from $318) | 68th percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $12K | 1% | $82 | $130 (top 5% from $458) | 20th percentile |
In this area
9 providers in McHenry County, IL carry an indicator in the public record, with $4.8M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 4.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | CRYSTAL PINES REHABILITATION AND HEALTH CARE CENTER, LLC Crystal Lake, IL, ranked 2250 | $0 |
|
| 3 | PEARL OF CRYSTAL LAKE, LLC Crystal Lake, IL, ranked 2930 | $0 |
|
| 3 | WILLOW OF MARENGO, INC Marengo, IL, ranked 5382 | $0 |
|
| 3 | HIGHLIGHT HEALTHCARE OF WOODSTOCK, LLC Woodstock, IL, ranked 5500 | $0 |
|
| 4 | AMANDA EANNARINO Mchenry, IL, ranked 8140 | $1.9M |
|
| 4 | CRISY GOWAN Crystal Lake, IL, ranked 8207 | $735K |
|
| 4 | KATHARINE HANSEN Crystal Lake, IL, ranked 8218 | $622K |
|
| 5 | VALERIE AUREL Crystal Lake, IL, ranked 10112 | $982K |
|
Recent enforcement in IL
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.