Pines, Michael

Pines, Michael was paid $1.96M by Medicaid between Jan 2018 and Oct 2023, across 3 billing codes. Its largest line is 90837, psychotherapy session, about an hour — 99% of everything it billed.

33Billing provider infoPINES, MICHAEL
GLASTONBURY, CT 06033

33aNPI1891887691assigned 09/29/2006

33bProvider typePsychologist

28Total paid$1.96M

24GClaims19,665

24DCodes billed3

24AFirst – last monthJan 2018 – Oct 2023

Compared with peers

Next to other Psychologist providers in Connecticut

Rank by total paid#2 of 39

Median peer was paid$48K

This provider vs. median41×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

OIG exclusionListed on the federal exclusion list (11/20/2024).

Single-Code Concentration99% of spending on code 90837 with only 3 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	3,030	$328K
2019	3,644	$325K
2020	3,734	$341K
2021	3,414	$341K
2022	3,291	$344K
2023	2,552	$279K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90837	Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient	99%	19,033	4,921	$1.93M
98968		<1%	322	104	$14K
98967		<1%	310	104	$13K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.