MIKE TIERNEY, CADC II
NPI 1659735165, individual, Portland, OR, Counselor, Addiction (Substance Use Disorder)
- Hours beyond a day in 2 months, but with up to 125 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Oct 2024 | More hours than a day holds at a conservative unit price | 1.0 | 43.2 | 28.8 | 38.8 | 106 | 1 | H0004 | $90K |
| Nov 2024 | More hours than a day holds at a conservative unit price | 1.4 | 42.0 | 28.0 | 40.0 | 125 | 1 | 99204 H0004 | $86K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MIKE TIERNEY, CADC II |
| Type | Individual |
| Status | Active |
| NPI issued | April 11, 2016, last updated November 2, 2023 |
| Practice location | 3580 SE 82ND AVE, Portland, OR 97266-2902, 971-339-9240 |
| Mailing address | 324 NW DAVIS STREET, Portland, OR 97209-9720 |
| Specialties | Counselor, Addiction (Substance Use Disorder) (101YA0400X, primary, license 14-03-33 OR) |
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 | |
|---|---|---|---|---|---|---|---|
| H0020 | Medicaid service code | $299K | 47% | $795 | $214 (top 5% from $529) | too few months to rank | |
| H0004 | Behavioral health counseling and therapy per 15 minhistory of abuse | $272K | 43% | $586 | $174 (top 5% from $559) | 95th percentile | |
| H0001 | Medicaid service code | $32K | 5% | $703 | $103 (top 5% from $301) | too few months to rank | |
| H0005 | Medicaid service code | $20K | 3% | $47 | $129 (top 5% from $479) | too few months to rank | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $7K | 1% | $257 | $95 (top 5% from $171) | too few months to rank |
In this area
14 providers in Multnomah County, OR carry an indicator in the public record, with $4.3M at stake between them. The most common is part of a provider network, on 7 of them, followed by more hours than a day holds on 6. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | JENNIFER JABLIN Portland, OR, ranked 102 | $264K |
|
| 3 | WESTERN HEALTH RESOURCES Portland, OR, ranked 1454 | $34K |
|
| 3 | TRADITIONS HOSPICE OF PORTLAND, LLC Portland, OR, ranked 1489 | $22K |
|
| 3 | WEST HILLS CONVALESCENT CENTER LIMITED PARTNERSHIP Portland, OR, ranked 2938 | $0 |
|
| 3 | WARM SPRINGS HOME HEALTH CARE INC Portland, OR, ranked 3840 | $0 |
|
| 3 | WESTERN HEALTH RESOURCES Portland, OR, ranked 4477 | $0 |
|
| 3 | PINNACLE HOSPICE CARE INC Portland, OR, ranked 4577 | $0 |
|
| 3 | ROSE CITY HOME HEALTH CARE INC Portland, OR, ranked 6121 | $0 |
|
Recent enforcement in OR
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.