Providers

AMY MONTANEZ

NPI 1881997609, individual, Napa, CA, Marriage & Family Therapist

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 1 month under one organization, which can be supervisory billing.
  • Records needed.
score 51 of 100, rank 8935, $1.2M 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Nov 2022More hours than a day holds, even counting one unit per claim line26.735.223.432.0215190837$108K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameAMY MONTANEZ
TypeIndividual
StatusActive
NPI issuedDecember 16, 2010, last updated May 8, 2023
Practice location3419 VALLE VERDE DR, Napa, CA 94558-2414, 707-721-2060
Specialties
Counselor, Mental Health (101YM0800X)
Marriage & Family Therapist (106H00000X, primary, license 105317 CA)

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
codewhat it ispaidshareper patient-monthtypicalrank among providers
H2012Behavioral health day treatment per hour$4.2M25%$852$677 (top 5% from $3K)55th percentile
H2019Therapeutic behavioral services per 15 min$4.1M25%$1K$226 (top 5% from $1K)92nd percentile
H0046Medicaid service code$3.7M22%$659$60 (top 5% from $2K)78th percentile
S5111Medicaid service code$2.0M12%$500$162 (top 5% from $591)94th percentile
90837Psychotherapy, 1 hourhistory of abuse$1.1M7%$198$191 (top 5% from $442)53rd percentile
T1014Medicaid service code$915K5%$78$14 (top 5% from $123)91st percentile
A0425Ground mileage, per statute mile$440K3%$212$33 (top 5% from $223)95th percentile
H0032Medicaid service code$233K1%$1K$98 (top 5% from $675)100th percentile

In this area

6 providers in Napa County, CA carry an indicator in the public record, with $97K at stake between them. The most common is part of a provider network, on 4 of them, followed by more hours than a day holds on 2.

tierproviderat stakewhy
3PETUNIA HOLDINGS, LLC
Napa, CA, ranked 1491
$21K
  • Part of provider network D1-00041, ranked 41 nationally.
3VETERANS HOME OF CALIFORNIA
Yountville, CA, ranked 2988
$0
  • Part of provider network D1-00138, ranked 138 nationally.
3DANNY'S HOME HEALTH CARE INC.
Napa, CA, ranked 3037
$0
  • Part of provider network D1-00045, ranked 45 nationally.
3NAPAIDENCE OPCO, LLC
Napa, CA, ranked 5022
$0
  • Part of provider network D1-00041, ranked 41 nationally.
4TERESA SHINDER
Saint Helena, CA, ranked 9597
$72K
  • Hours beyond a day in 8 months, but with up to 1729 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4DAVID GORCHOFF
Napa, CA, ranked 9762
$4K
  • Hours beyond a day in 1 month, but with up to 1549 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.

Recent enforcement in CA

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJPleaded guiltyAug 27, 2026
Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare
Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit
Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit
Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.

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