Providers
All 14 in MA
SOPHIA A BARTONE, LMFT, CADC-I
NPI 1679919666, individual, Boston, MA, Marriage & Family Therapist
2
Evidence tier
impossible volume with concurrency
- Billed more hands-on hours than a day holds in 4 months, peaking at 17.9 hours per day across 3 billing organizations.
score 81 of 100, rank 734, $567K 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 |
|---|---|---|---|---|---|---|---|---|---|
| Mar 2018 | More hours than a day holds, even counting one unit per claim line | 24.9 | 22.0 | 14.7 | 20.7 | 200 | 3 | 90876 | $83K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 25.1 | 25.2 | 16.8 | 22.6 | 152 | 2 | 90876 | $94K |
| Jun 2018 | More hours than a day holds, even counting one unit per claim line | 31.2 | 26.9 | 17.9 | 25.6 | 190 | 2 | 90876 | $97K |
| Jul 2018 | More hours than a day holds, even counting one unit per claim line | 32.0 | 20.2 | 13.4 | 18.9 | 196 | 2 | 90876 | $76K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SOPHIA A BARTONE, LMFT, CADC-I |
| Type | Individual |
| Status | Active |
| NPI issued | May 16, 2013, last updated May 16, 2025 |
| Practice location | 101 ARCH ST, Boston, MA 02110-1130, 702-723-8822 |
| Specialties | Counselor, Addiction (Substance Use Disorder) (101YA0400X, license CADC-I 01106 NV) Marriage & Family Therapist (106H00000X, primary, license MFT-01480 NV) |
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 | |
|---|---|---|---|---|---|---|---|
| 90876 | Psychophysiological therapy with biofeedback 45 min | $779K | 60% | $490 | $392 (top 5% from $816) | 65th percentile | |
| S9480 | Intensive outpatient psychiatric services per diem | $290K | 23% | $1K | $946 (top 5% from $4K) | 69th percentile | |
| H2011 | Crisis intervention service per 15 min | $126K | 10% | $976 | $181 (top 5% from $3K) | 82nd percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $53K | 4% | $162 | $191 (top 5% from $442) | 37th percentile | |
| 90901 | Biofeedback training | $18K | 1% | $115 | $45 (top 5% from $503) | too few months to rank | |
| H0031 | Medicaid service code | $11K | 1% | $169 | $100 (top 5% from $540) | too few months to rank | |
| H0002 | Medicaid service code | $4K | 0% | $31 | $34 (top 5% from $215) | 46th percentile | |
| Q3014 | Telehealth originating site facility fee | $3K | 0% | $21 | $21 (top 5% from $84) | 51st percentile |
In this area
14 providers in Suffolk County, MA carry an indicator in the public record, with $3.7M at stake between them. The most common is part of a provider network, on 11 of them, followed by named in an enforcement record on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | CHELSEA JEWISH COMMUNITY, INC. Chelsea, MA, ranked 1022 | $1.3M |
|
| 3 | CHELSEA JEWISH NURSING HOME, INC. Chelsea, MA, ranked 1174 | $435K |
|
| 3 | DEUTSCHES ALTENHEIM INC. West Roxbury, MA, ranked 1175 | $434K |
|
| 3 | SHERRILL HOUSE, INC Boston, MA, ranked 1208 | $342K |
|
| 3 | CHELSEA JEWISH GREEN HOUSE, INC Chelsea, MA, ranked 1251 | $253K |
|
| 3 | ASHMONT HILL, LLC Dorchester, MA, ranked 1259 | $246K |
|
| 3 | ARMENIAN NURSING AND REHABILITATION CENTER, INC. Jamaica Plain, MA, ranked 1455 | $34K |
|
| 3 | BOSTON HOME INC Boston, MA, ranked 1472 | $27K |
|
Recent enforcement in MA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedSep 4, 2026
Illegal Alien from Georgia Charged for Conspiracy to Launder Proceeds of $1.3B Health Care Fraud Scheme
Gugava purportedly owned ND Medical Solutions LLC, a durable medical equipment company that submitted at least $1.3 billion in fraudulent DME claims to Medicare and other insurers using stolen identities, and he opened bank accounts to deposit and transfer the fraud proceeds to overseas accounts.
DOJIndictedSep 4, 2026
Georgian National Charged for Conspiracy to Launder Proceeds of $1.3 Billion Health Care Fraud Scheme
Gugava allegedly served as purported owner of ND Medical Solutions, LLC, which submitted at least $1.3 billion in fraudulent durable medical equipment claims to Medicare and private insurers using stolen identities, and he opened bank accounts to deposit and transfer the proceeds overseas.
DOJSentencedAug 20, 2026
Former Owner of Telemedicine Companies Sentenced to Two Years in Prison for $110 Million Medicare Fraud Scheme
Through his telemedicine companies, Richardson generated prepopulated durable medical equipment orders signed by doctors and nurses without beneficiary contact and sold them to telemarketers who resold them to DME suppliers that billed Medicare for medically unnecessary equipment.
DOJCivil settlementAug 10, 2026
Veloxis Pharmaceuticals Agrees to Pay $46 Million to Resolve Criminal and Civil Liability for Kickback Scheme
Veloxis paid kickbacks in the form of lavish meals, alcohol, luxury resort stays, personal gifts and sham consulting payments to transplant health care professionals, and per-patient and per-month payments to specialty pharmacies, to induce prescriptions and purchases of Envarsus XR, causing false claims to federal health care programs and underreporting payments under the Open Payments Program.
DOJCivil settlementAug 10, 2026
Veloxis Pharmaceuticals Agrees to Pay Over $46M to Resolve Criminal and Civil Liability for Kickback Schemes
Veloxis paid kickbacks in the form of lavish meals, alcohol, gifts, trips and resort stays, and purported consulting fees to health care providers, and per-patient and per-month payments to specialty pharmacies, to induce prescriptions and purchases of Envarsus XR, and concealed those payments through falsified expense reports that resulted in underreporting to CMS's Open Payments Program.
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.