KARL WINEGAR, LCSW
NPI 1780138206, individual, Prairieville, LA, Social Worker, Clinical
- Hours beyond a day in 6 months, but with up to 901 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 2019 | More hours than a day holds, even counting one unit per claim line | 46.1 | 44.1 | 29.4 | 20.0 | 901 | 1 | 90791 90834 90837 90846 90847 H0038 H2017 S5150 T1016 T1017 | $185K |
| Nov 2019 | More hours than a day holds, even counting one unit per claim line | 38.0 | 42.1 | 28.1 | 21.8 | 881 | 1 | 90791 90834 90837 90846 90847 H0038 H2017 S5150 T1016 T1017 | $166K |
| Mar 2020 | More hours than a day holds, even counting one unit per claim line | 35.4 | 45.4 | 30.3 | 19.5 | 786 | 1 | 90791 90834 90837 90846 90847 H0038 H2017 T1017 | $162K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 37.8 | 46.4 | 30.9 | 20.9 | 741 | 1 | 90791 90834 90846 90847 H0038 H2017 S5150 T1017 | $157K |
| May 2020 | More hours than a day holds, even counting one unit per claim line | 36.7 | 45.8 | 30.5 | 21.7 | 777 | 1 | 90791 90832 90834 90846 90847 H0038 H2017 S5150 T1017 | $165K |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 36.0 | 46.2 | 30.8 | 18.9 | 783 | 1 | 90791 90834 90846 90847 H0038 H2017 S5150 T1017 | $164K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | KARL WINEGAR, LCSW |
| Type | Individual |
| Status | Active |
| NPI issued | August 12, 2016, last updated June 2, 2022 |
| Practice location | 37283 SWAMP RD STE 803, Prairieville, LA 70769-3329, 208-821-1032 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license LCSW-36001 ID) |
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 | |
|---|---|---|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | $1.0M | 20% | $151 | $101 (top 5% from $318) | 73rd percentile | |
| T1017 | Targeted case management each 15 min | $1.0M | 20% | $175 | $167 (top 5% from $808) | 51st percentile | |
| H0038 | Self-help/peer services per 15 min | $901K | 17% | $349 | $147 (top 5% from $2K) | 75th percentile | |
| H2017 | Psychosocial rehabilitation services per 15 minhistory of abuse | $680K | 13% | $380 | $310 (top 5% from $1K) | 61st percentile | |
| H0046 | Medicaid service code | $268K | 5% | $256 | $60 (top 5% from $2K) | 66th percentile | |
| T1016 | Case management each 15 min | $253K | 5% | $154 | $98 (top 5% from $507) | 65th percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $211K | 4% | $175 | $130 (top 5% from $458) | 69th percentile | |
| H0032 | Medicaid service code | $161K | 3% | $79 | $98 (top 5% from $675) | 39th percentile |
In this area
3 providers in Ascension Parish County, LA carry an indicator in the public record, with $3.9M at stake between them. The most common is part of a provider network, on 2 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | BATON ROUGE HOMECARE, LLC Gonzales, LA, ranked 1234 | $281K |
|
| 3 | A-1 BAYOU HEALTH 2000, INC. Gonzales, LA, ranked 6632 | $0 |
|
| 4 | BRANDI MOORE Gonzales, LA, ranked 8483 | $3.7M |
|
Recent enforcement in LA
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.