LUCINDA J MCCARTNEY, FNP-BC
NPI 1881843258, individual, Morgantown, WV, Nurse Practitioner, Family
- Hours beyond a day in 1 month, but with up to 916 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99213 ($127 per patient-month) sit in the top 5% of every provider billing that code.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 24.2 | 32.4 | 21.6 | 29.5 | 916 | 1 | 90853 99212 99213 99401 | $105K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | LUCINDA J MCCARTNEY, FNP-BC |
| Type | Individual |
| Status | Active |
| NPI issued | September 10, 2008, last updated July 8, 2014 |
| Practice location | 699 BURROUGHS ST, Morgantown, WV 26505-3346, 304-225-9356 |
| Specialties | Nurse Practitioner, Family (363LF0000X, primary, license 49892 WV) |
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 | |
|---|---|---|---|---|---|---|---|
| G9012 | Medicaid service code | $398K | 46% | $283 | $232 (top 5% from $425) | 78th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $216K | 25% | $127 | $44 (top 5% from $110) | 96th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $80K | 9% | $65 | $60 (top 5% from $133) | 55th percentile | |
| 99401 | Preventive counseling individual 15 min | $72K | 8% | $62 | $16 (top 5% from $46) | too few months to rank | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $52K | 6% | $65 | $28 (top 5% from $147) | 86th percentile | |
| 80305 | Testing for presence of drug, read by direct observation | $30K | 3% | $15 | $9.23 (top 5% from $22) | 83rd percentile | |
| 90853 | Group psychotherapyhistory of abuse | $6K | 1% | $13 | $60 (top 5% from $332) | too few months to rank | |
| 99340 | Medicaid service code | $5K | 1% | $111 | $142 (top 5% from $170) | too few months to rank |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 48 | 12 | $4K | $315 | $103 | 3.1x | 2.3x (90th percentile 3.8x) |
| 80305 | Testing for presence of drug, read by direct observation | 50 | 11 | $618 | $63 | $12 | 5.1x | 3.2x (90th percentile 8.2x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
4 providers in Monongalia County, WV carry an indicator in the public record, with $1.3M at stake between them. The most common is more hours than a day holds, on 4 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 5 | SANJAY BHARTI Morgantown, WV, ranked 10247 | $530K |
|
| 5 | TIARA DEAN Morgantown, WV, ranked 11305 | $364K | |
| 5 | MICHELLE CARDI Morgantown, WV, ranked 11308 | $358K | |
| 5 | DANIEL FARMER Morgantown, WV, ranked 11788 | $41K |
Recent enforcement in WV
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.