Providers

JOANNA LYON, LCPC

NPI 1639369093, individual, Bozeman, MT, Counselor, Professional

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 4 months under one organization, which can be supervisory billing.
  • Records needed.
  • 63% of Medicaid dollars are on codes with a history of abuse.
score 51 of 100, rank 8559, $30K 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Apr 2019More hours than a day holds, even counting one unit per claim line60.53.42.23.134190837$9K
May 2019More hours than a day holds, even counting one unit per claim line27.03.12.12.844190837 90847$8K
Aug 2019More hours than a day holds, even counting one unit per claim line25.03.12.12.944190837 90847$8K
Apr 2020More hours than a day holds, even counting one unit per claim line25.91.91.31.724190837$5K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameJOANNA LYON, LCPC
TypeIndividual
StatusActive
NPI issuedJuly 31, 2007, last updated February 10, 2025
Practice location2245 W KOCH ST, Bozeman, MT 59718-4010, 406-595-6396
Mailing address317 SLOUGH CREEK DR, Bozeman, MT 59718-2002
Specialties
Counselor, Professional (101YP2500X)
Counselor, Professional (101YP2500X, primary, license 1278 MT)

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
codewhat it ispaidshareper patient-monthtypicalrank among providers
90837Psychotherapy, 1 hourhistory of abuse$132K63%$208$191 (top 5% from $442)57th percentile
90834Psychotherapy, 45 minutes$45K21%$125$101 (top 5% from $318)63rd percentile
90847Family psychotherapy with patient, 50 minutes$25K12%$112$130 (top 5% from $458)40th percentile
90846Family psychotherapy without patient, 50 minutes$7K4%$98$113 (top 5% from $277)39th percentile

In this area

4 providers in Gallatin County, MT carry an indicator in the public record, with $621K at stake between them. The most common is part of a provider network, on 2 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1JONATHAN WILHELM
Belgrade, MT, ranked 238
$21K
  • Listed on the Medicare revocation list since December 4, 2020.
  • Medicaid still paid claims in 17 later months, $21,466 in total.
3EDEN HOME HEALTH OF BOZEMAN, LLC
Bozeman, MT, ranked 2580
$0
  • Part of provider network D1-00079, ranked 79 nationally.
3EDEN HOSPICE AT WESTERN MONTANA, LLC
Bozeman, MT, ranked 3324
$0
  • Part of provider network D1-00079, ranked 79 nationally.
5CHRISTOPHER CROWLEY
Bozeman, MT, ranked 10223
$599K
  • Medicaid dollars per patient on code 99214 ($138 per patient-month) sit in the top 5% of every provider billing that code.

Recent enforcement in MT

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJSentencedJan 17, 2025
Former nurse practitioner in Butte sentenced to five years in prison, ordered to pay more than $600,000 restitution for health care fraud
A former nurse practitioner falsely billed Blue Cross Blue Shield of Montana $62,310,000 for 158 vitamin B-12 injections that did not occur, receiving $613,108, and used another nurse practitioner's DEA registration number to write prescriptions after her own license was suspended.
DOJSentencedDec 13, 2024
Whitefish doctor sentenced for defrauding Medicare and other federal health programs
Dean was paid by a telemedicine company to sign orders for durable medical equipment that patients did not need, and he fraudulently charged Medicare, CHAMPVA and Railroad Retirement Board programs for telemedicine office visits that did not occur while also authorizing unnecessary covid tests.
DOJPleaded guiltyAug 2, 2024
Former nurse practitioner in Butte admits health care fraud; received nearly $600,000 in false claims
A former nurse practitioner prescribed controlled substances after her license was suspended, using another nurse practitioner's name and DEA registration number, and billed Blue Cross Blue Shield of Montana at least $61,995,000 for vitamin B-12 injections that did not occur, receiving at least $593,583.
DOJPleaded guiltyJul 18, 2024
Whitefish doctor admits defrauding Medicare and other federal health programs
Dean, a licensed physician, was paid by a telemedicine company to sign orders for durable medical equipment that patients did not need and then billed Medicare, CHAMPVA and the Railroad Retirement Board programs for telemedicine office visits that did not occur, resulting in more than $39 million in false billing.
DOJChargedJun 27, 2024
National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims
Dean was paid by a telemedicine company to sign orders for durable medical equipment patients did not need and fraudulently charged Medicare and other government health programs for telemedicine office visits that did not occur, resulting in over $39 million in false billing.

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.

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