TERRI L PONDER, LCSW
NPI 1679812895, individual, Tullahoma, TN, Social Worker, Clinical
- Hours beyond a day in 2 months, but with up to 400 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- 60% 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 |
|---|---|---|---|---|---|---|---|---|---|
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 25.1 | 35.2 | 23.4 | 32.0 | 211 | 1 | 90791 90832 90834 90837 | $67K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 24.7 | 34.8 | 23.2 | 34.3 | 230 | 1 | 90791 90832 90834 90837 | $69K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | TERRI L PONDER, LCSW |
| Type | Individual |
| Status | Active |
| NPI issued | February 7, 2013, last updated March 8, 2021 |
| Practice location | 1803 N JACKSON ST, Tullahoma, TN 37388-2201, 931-461-1300 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license 4623 TN) |
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 | $309K | 60% | $228 | $191 (top 5% from $442) | 65th percentile | |
| 90832 | Psychotherapy, 30 minutes | $121K | 24% | $40 | $59 (top 5% from $239) | 32nd percentile | |
| 90834 | Psychotherapy, 45 minutes | $50K | 10% | $44 | $101 (top 5% from $318) | 18th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $35K | 7% | $196 | $105 (top 5% from $228) | 92nd percentile | |
| 3008F | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $1.17) | too few months to rank |
In this area
3 providers in Coffee County, TN carry an indicator in the public record, with $1.2M at stake between them. The most common is more hours than a day holds, on 2 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | HARRISON YANG Manchester, TN, ranked 386 | $1K |
|
| 5 | DANIEL MANSFIELD Tullahoma, TN, ranked 11120 | $739K | |
| 5 | CYNTHIA YOUNG Tullahoma, TN, ranked 11250 | $442K |
Recent enforcement in TN
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.