JOHN BARSOTTI
NPI 1942672209, individual, Knoxville, TN, Social Worker, Clinical
- Hours beyond a day in 4 months, but with up to 234 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 90837 ($449 per patient-month) sit in the top 5% of every provider billing that code.
- 76% 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 | 27.3 | 51.1 | 34.1 | 46.4 | 227 | 1 | 90791 90832 90834 90837 | $98K |
| Oct 2022 | More hours than a day holds at a conservative unit price | 21.6 | 40.6 | 27.1 | 40.0 | 201 | 1 | 90791 90832 90834 90837 | $80K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 29.8 | 57.0 | 38.0 | 51.8 | 234 | 1 | 90791 90832 90834 90837 | $108K |
| Jan 2023 | More hours than a day holds at a conservative unit price | 21.4 | 39.5 | 26.4 | 37.2 | 217 | 1 | 90791 90834 90837 | $79K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JOHN BARSOTTI |
| Type | Individual |
| Status | Active |
| NPI issued | October 27, 2015, last updated April 18, 2023 |
| Practice location | 320 N PETERS RD STE C, Knoxville, TN 37922-7509, 901-413-5807 |
| Mailing address | 1205 HIGHLAND DR, Chattanooga, TN 37405-2317 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license 7155 TN) Counselor, Mental Health (101YM0800X, license 10488 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 | $630K | 76% | $449 | $191 (top 5% from $442) | 95th percentile | |
| 90834 | Psychotherapy, 45 minutes | $127K | 15% | $170 | $101 (top 5% from $318) | 78th percentile | |
| 90832 | Psychotherapy, 30 minutes | $43K | 5% | $159 | $59 (top 5% from $239) | 90th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $30K | 4% | $246 | $105 (top 5% from $228) | 96th percentile |
In this area
30 providers in Knox County, TN carry an indicator in the public record, with $35.7M at stake between them. The most common is more hours than a day holds, on 24 of them, followed by named in an enforcement record on 3. 3 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ROCKY HILL PHARMACY, LLC Knoxville, TN, ranked 582 | $0 |
|
| 1 | HOLLI WOMACK Knoxville, TN, ranked 653 | $0 |
|
| 1 | CYNTHIA CLEMONS Knoxville, TN, ranked 681 | $0 |
|
| 3 | WELLPARK HEALTHCARE CENTER, LLC Knoxville, TN, ranked 4309 | $0 |
|
| 3 | PRESBYTERIAN HOMES OF TENNESSEE, INC. Knoxville, TN, ranked 6805 | $0 |
|
| 3 | SHALOM HOSPICE OF GREATER KNOXVILLE LLC Knoxville, TN, ranked 7248 | $0 |
|
| 4 | JAN FINE Knoxville, TN, ranked 7802 | $1.2M |
|
| 4 | CYNTHIA HARMON Knoxville, TN, ranked 8172 | $1.2M |
|
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.