Providers
All 28 in MN
PAUL MICHAEL NOVOTNY, MA, LPCC
NPI 1609102870, individual, Saint Paul, MN, Counselor, Mental Health
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 40 months, but with up to 938 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 90785 ($39 per patient-month) sit in the top 5% of every provider billing that code.
- 85% of Medicaid dollars are on codes with a history of abuse.
score 58 of 100, rank 7277, $15.3M 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.
| 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 2021 | More hours than a day holds, even counting one unit per claim line | 49.8 | 134.5 | 89.6 | 22.8 | 892 | 3 | 90791 90832 90834 90837 H2017 T1013 | $303K |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 49.6 | 138.4 | 92.3 | 21.5 | 920 | 3 | 90791 90832 90834 90837 H2017 T1013 | $344K |
| Apr 2021 | More hours than a day holds, even counting one unit per claim line | 50.6 | 139.9 | 93.3 | 22.4 | 907 | 3 | 90791 90832 90834 90837 H2017 T1013 | $337K |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 47.5 | 133.2 | 88.8 | 21.1 | 900 | 3 | 90791 90832 90834 90837 H2017 T1013 | $320K |
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 46.6 | 128.6 | 85.8 | 23.1 | 902 | 3 | 90791 90832 90834 90837 H2017 T1013 | $321K |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 45.4 | 126.3 | 84.2 | 22.2 | 872 | 3 | 90791 90832 90837 H2017 T1013 | $315K |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 47.4 | 133.6 | 89.1 | 21.5 | 857 | 3 | 90791 90832 90837 H2017 T1013 | $321K |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 48.6 | 130.6 | 87.1 | 25.6 | 874 | 3 | 90791 90832 90834 90837 H2017 T1013 | $326K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 47.7 | 134.5 | 89.7 | 24.6 | 890 | 3 | 90791 90832 90834 90837 H2017 T1013 | $326K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 49.7 | 143.7 | 95.8 | 24.6 | 938 | 3 | 90791 90832 90834 90837 H2017 T1013 | $359K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 41.8 | 114.3 | 76.2 | 29.0 | 793 | 3 | 90791 90832 90834 90837 H2017 T1013 | $292K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 43.8 | 115.9 | 77.2 | 27.4 | 807 | 2 | 90791 90832 90834 90837 H2017 T1013 | $268K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 48.6 | 111.6 | 74.4 | 27.1 | 842 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $286K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 48.8 | 118.1 | 78.8 | 33.7 | 830 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $296K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 48.6 | 121.9 | 81.3 | 31.4 | 822 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $313K |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 53.1 | 135.7 | 90.5 | 34.0 | 879 | 3 | 90791 90832 90834 90837 90853 99354 H2017 T1013 | $337K |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 50.8 | 133.2 | 88.8 | 35.4 | 887 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $342K |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 54.9 | 143.9 | 95.9 | 35.5 | 916 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $370K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 57.4 | 143.2 | 95.4 | 37.6 | 910 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $357K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 55.1 | 142.7 | 95.1 | 40.4 | 923 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $367K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 57.8 | 153.8 | 102.5 | 35.6 | 895 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $379K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 51.2 | 143.1 | 95.4 | 32.9 | 864 | 2 | 90791 90832 90834 90837 90853 H2017 T1013 | $364K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 56.1 | 153.0 | 102.0 | 36.2 | 922 | 2 | 90791 90832 90834 90837 90853 H2017 T1013 | $397K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 57.0 | 156.5 | 104.3 | 37.0 | 889 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $367K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 55.0 | 162.1 | 108.1 | 35.5 | 886 | 2 | 90791 90832 90834 90837 90853 H2017 T1013 | $419K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 53.5 | 149.7 | 99.8 | 39.3 | 858 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $377K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 55.6 | 161.8 | 107.9 | 36.6 | 873 | 3 | 90791 90832 90834 90837 90853 H2017 T1013 | $419K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 49.5 | 155.3 | 103.5 | 32.7 | 851 | 1 | 90791 90832 90834 90837 90853 H2017 T1013 | $388K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 45.8 | 143.1 | 95.4 | 32.5 | 798 | 2 | 90791 90832 90834 90837 90853 H2017 | $369K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 48.0 | 146.7 | 97.8 | 31.5 | 777 | 2 | 90791 90832 90834 90837 90853 H2017 | $378K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 46.8 | 140.2 | 93.5 | 31.6 | 778 | 2 | 90791 90832 90834 90837 90853 H2017 | $350K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 47.3 | 144.9 | 96.6 | 30.6 | 800 | 2 | 90791 90832 90834 90837 90853 H2017 | $373K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 45.1 | 141.7 | 94.5 | 27.2 | 778 | 1 | 90791 90832 90834 90837 90853 H2017 | $351K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 45.7 | 135.0 | 90.0 | 30.8 | 805 | 2 | 90791 90832 90834 90837 90853 H2017 | $348K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 52.4 | 157.7 | 105.1 | 34.2 | 867 | 1 | 90791 90832 90834 90837 90853 H2017 T1013 | $414K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 52.5 | 152.0 | 101.4 | 35.8 | 848 | 2 | 90791 90832 90834 90837 90853 H2017 T1013 | $375K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 48.2 | 137.4 | 91.6 | 34.0 | 814 | 2 | 90791 90832 90834 90837 90853 H2017 T1013 | $361K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 41.1 | 95.3 | 63.5 | 29.5 | 748 | 2 | 90791 90832 90834 90837 90853 H2017 T1013 | $251K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 56.0 | 183.7 | 122.5 | 34.6 | 847 | 2 | 90791 90832 90834 90837 90853 H2017 | $477K |
| Nov 2024 | More hours than a day holds, even counting one unit per claim line | 47.7 | 155.2 | 103.5 | 30.5 | 770 | 1 | 90791 90832 90834 90837 90853 H2017 | $389K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PAUL MICHAEL NOVOTNY, MA, LPCC |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | October 23, 2009, last updated October 23, 2009 |
| Practice location | 1919 UNIVERSITY AVE W STE 6, Saint Paul, MN 55104-3453, 651-636-8677 |
| Mailing address | 1375 DAVERN STREET #319, St. Paul, MN 55116 |
| Specialties | Counselor, Mental Health (101YM0800X, primary, license cc00065 MN) |
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
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H2017 | Psychosocial rehabilitation services per 15 minhistory of abuse | $10.5M | 60% | $528 | $310 (top 5% from $1K) | 72nd percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $4.3M | 25% | $372 | $191 (top 5% from $442) | 92nd percentile | |
| T1013 | Sign language or oral interpretive services per 15 min | $1.0M | 6% | $240 | $20 (top 5% from $260) | 95th percentile | |
| 90785 | Psychiatric services complicated by communication factor | $408K | 2% | $39 | $15 (top 5% from $35) | 97th percentile | |
| H0046 | Medicaid service code | $355K | 2% | $44 | $60 (top 5% from $2K) | 44th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $317K | 2% | $137 | $105 (top 5% from $228) | 77th percentile | |
| H0031 | Medicaid service code | $174K | 1% | $94 | $100 (top 5% from $540) | 48th percentile | |
| 90832 | Psychotherapy, 30 minutes | $169K | 1% | $84 | $59 (top 5% from $239) | 73rd percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 366 | 21 | $36K | $200 | $129 | 1.5x | 1.6x (90th percentile 2.9x) |
| 90791 | Psychiatric diagnostic evaluation | 33 | 31 | $3K | $248 | $144 | 1.7x | 1.9x (90th percentile 3.6x) |
| 90785 | Psychiatric services complicated by communication factor | 127 | 17 | $1K | $20 | $13 | 1.6x | 2.4x (90th percentile 7.3x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
28 providers in Ramsey County, MN carry an indicator in the public record, with $34.5M at stake between them. The most common is more hours than a day holds, on 12 of them, followed by part of a provider network on 8. 4 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | EVERGREEN RECOVERY Saint Paul, MN, ranked 37 | $13.8M |
|
| 1 | SHAWN GRYGO Saint Paul, MN, ranked 223 | $27K |
|
| 1 | MIDWEST MEDICAL SERVICES, INC. Mounds View, MN, ranked 244 | $20K |
|
| 1 | MIDWEST MEDICAL HOLDINGS LLC Saint Paul, MN, ranked 430 | $233 |
|
| 3 | CAREMATE HOME HEALTH CARE, INC. ST Paul, MN, ranked 838 | $2.0M |
|
| 3 | SAFELODGINGS Saint Paul, MN, ranked 1094 | $695K |
|
| 3 | LIBERTY PLUS LLC Roseville, MN, ranked 1109 | $638K |
|
| 3 | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY Saint Paul, MN, ranked 2440 | $0 |
|
Recent enforcement in MN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJOtherMay 22, 2026
This Week in Fraud: The Fraud Division Announced Expansion of Midwest Task Force and Authorization to Hire 15 New Medicaid Prosecutors, an Unprecedented Minnesota Health Care Fraud Takedown, and a $2 Billion Telemedicine Health Care Fraud Scheme
The Justice Department announced charges against 15 defendants for Medicaid fraud schemes totaling over $90 million in intended loss, a 10-year sentence in a $2 billion international health care fraud conspiracy in Brooklyn, and a Michigan jury conviction of a nurse who bribed a Detroit hospital nurse for confidential records used to bill Medicare in a $1.6 million scheme, along with expansion of the Health Care Fraud Midwest Strike Force and hiring of 15 additional Medicaid fraud prosecutors.
DOJChargedMay 21, 2026
Minnesota Health Care Fraud Takedown Results in Charges Against 15 Defendants for Over $90M in Fraud
Fifteen defendants were charged in connection with schemes involving over $90 million in intended loss against Minnesota Medicaid programs, including paying kickbacks to parents and billing for autism, Integrated Community Supports, Individualized Home Supports, Housing Stabilization Services and child care services that were not provided as represented.
DOJPleaded guiltyFeb 10, 2026
Fraud Tourists Plead Guilty to Minneapolis Medicaid Fraud
Two men set up businesses in Minneapolis, enrolled as Housing Stabilization Services providers, recruited Medicaid beneficiaries at homeless shelters and Section 8 housing, billed for services not provided, and used ChatGPT and fabricated e-mails to create fake client records when asked for documentation.
DOJChargedSep 24, 2025
First Defendant Charged in Autism Fraud Scheme
Hassan and others enrolled Smart Therapy LLC as an EIDBI autism services provider, recruited children with cash kickbacks to parents, employed unqualified behavioral technicians, and submitted inflated and fabricated Medicaid claims for services not provided, obtaining more than $14 million, while also submitting approximately $465,000 in fraudulent Federal Child Nutrition Program claims through Feeding Our Future.
DOJCivil settlementJun 26, 2025
NUWAY Alliance Agrees to Pay $18,500,000 Settlement in Medicaid Kickbacks Scheme, False Claims Act Violations
NUWAY compensated Medicaid patients for seeking intensive outpatient treatment in violation of the federal anti-kickback statute and submitted false claims for IOP services not provided by double-billing the same period of time as distinct billable units.
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.