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NPI 1023175072 · Springfield, MA · Methadone Clinic
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Habit Opco, LLC is a methadone clinic provider located in Springfield, Massachusetts. This profile covers 6 Medicare and 28 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Habit Opco, LLC |
| Address | 511 East Columbus Ave. |
| City | Springfield |
| State | MA |
| ZIP | 01105 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | January 2, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $224.1M |
| Medicare | $11M |
HABIT OPCO, LLC operates as a high-volume opioid treatment program consistent with its Methadone Clinic taxonomy: its Medicare and Medicaid top codes are service bundles and methadone administration codes (notably G2067 and H0020) that include dispensing, counseling, group therapy and toxicology testing. Medicare activity shows G2067 (38.5K claims, $244 avg paid/claim, $9.4M revenue) as the primary revenue driver for that payer, while Medicaid activity is dominated by methadone administration and clinic encounter codes such as H0020 (8.4M claims, $14 avg paid/claim, $118.1M revenue) and G2067 (534.5K claims, $120 avg paid/claim, $64.1M revenue).
Revenue concentration is pronounced for both payers: the provider’s top 3 Medicare codes account for 98.8% of its Medicare revenue, with G2067 alone representing $9.4M (85.1% of Medicare revenue); similarly, the top 3 Medicaid codes account for 87.9% of Medicaid revenue, driven by H0020 ($118.1M, 52.6%), G2067 ($64.1M, 28.5%), and T1015 ($15.3M, 6.8%).
The payer mix is skewed heavily toward Medicaid: lifetime Medicaid revenue is $224.1M compared with $11M in Medicare, indicating the organization is effectively Medicaid-dominant in scale and that most financial exposure and operational volume are tied to state Medicaid reimbursement and rules. This concentration suggests payer-specific risk and contract negotiation leverage will be far more relevant on the Medicaid side.
HABIT OPCO is a market leader on its core treatment codes at different geographies: for Medicare G2067 it ranks #1 of 830 providers nationally (100th percentile; extreme outlier), and for Medicaid H0020 it ranks #1 of 38 providers in-state (100th percentile; extreme outlier). Multiple other OTP codes (G2078, G2074, G2076, G2077) also appear at or near the top of their peer distributions, supporting characterization as a dominant statewide provider with nationally exceptional Medicare OTP billing for certain codes.
Operational footprint implications are apparent from the raw volumes: Medicaid H0020 shows 8.4M claims and G2067 has 534.5K Medicaid claims, while Medicare G2067 shows 38.5K claims — these volumes imply very large daily patient throughput, substantial medication dispensing and inventory operations, and ongoing needs for counseling, group therapy, and toxicology testing resources. The large number of take-home supply claims (G2078: 23.2K Medicare claims; 180K Medicaid claims) highlights significant operational management of multi-day supplies and associated compliance workflows.
The provider’s behavioral health and case-management mix supports a comprehensive OTP model rather than a narrow dispensing-only service: high Medicaid volumes for H0004 (38.7K claims, $2.1M revenue), H0005 (107.8K claims, $1.7M revenue, rank #1 in-state), G9012 (40.1K claims, $10.7M revenue), and 90853 (40.3K claims, $1.4M revenue) indicate regular use of counseling, group therapy, and case management as part of treatment bundles. These ancillary service volumes align with bundled OTP codes and suggest integrated psychosocial services are a material part of revenue and care delivery.
Statistical outlier labels in the source data corroborate dominance on core codes: several leading codes are flagged as "extreme outlier" (e.g., Medicare G2067 and Medicaid H0020 and G2067) or "notably above typical" (e.g., T1015, H0004), reinforcing that this provider’s OTP activity is far above typical peer volumes and that benchmarking or capacity comparisons should account for its outlier status.
The NPI tenure indicates institutional stability: the provider was enumerated on 2007-01-02 (~19 years ago), suggesting a long operational history that aligns with the large cumulative Medicaid and Medicare revenue base reported.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 38,540 | $240 | $9.4M |
| G2078 | Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | 23,240 | $40 | $883.1K |
| G2074 | Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services… | 3,210 | $200 | $629K |
| G2077 | Periodic assessment; assessing periodically by an otp practitioner and includes a review of moud dosing, treatment response, other substance use disorder treatment needs, responses and… | 580 | $120 | $67.3K |
| G2076 | Intake activities, including initial medical examination that is conducted by an appropriately licensed practitioner and preparation of a care plan, which may be informed by administration of a… | 230 | $170 | $39K |
| G2172 | All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project | 70 | $330 | $24.5K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
28 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 8,438,600 | $10 | $118.1M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 534,450 | $120 | $64.1M |
| T1015 | Clinic visit/encounter, all-inclusive | 130,680 | $120 | $15.3M |
| G9012 | Other specified case management service not elsewhere classified | 40,060 | $270 | $10.7M |
| G2078 | Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | 180,010 | $20 | $4M |
| G2074 | Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services… | 45,550 | $80 | $3.4M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 38,700 | $50 | $2.1M |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 107,810 | $20 | $1.7M |
| 90853 | Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of… | 40,300 | $30 | $1.4M |
| G2076 | Intake activities, including initial medical examination that is conducted by an appropriately licensed practitioner and preparation of a care plan, which may be informed by administration of a… | 7,760 | $140 | $1.1M |
Showing 1–10 of 28
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
28 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 1 | 40 | 26,400 | $10 | $9.7M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 1 | 30 | 8,280 | $140 | $8M |
| H2015 | Comprehensive community support services, per 15 minutes | 76 | 150 | 7,770 | $140 | $4.8M |
| G9012 | Other specified case management service not elsewhere classified | 1 | 10 | 3,300 | $270 | $3.9M |
| H2016 | Comprehensive community support services, per diem | 67 | 80 | 4,550 | $30 | $1.6M |
| T1015 | Clinic visit/encounter, all-inclusive | 14 | 550 | 90 | $140 | $1.5M |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 85 | 410 | 140 | $110 | $742.2K |
| 90834 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 276 | 1,620 | 580 | $80 | $599.6K |
| G2074 | Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services… | 1 | 10 | 1,140 | $90 | $518.2K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 2 | 30 | 3,380 | $50 | $460K |
Showing 1–10 of 28
Other providers in the same ZIP code as Habit Opco, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Commonwealth Of Massachusets | MA | Case Management Agency | $0 | $465.2M |
| Mental Health Association, Inc. | MA | Community/Behavioral Health Agency | $0 | $18.8M |
| Depatment Of Mental Health | MA | Case Management Agency | $0 | $14.2M |
| Colony Care Senior Living, Inc. | MA | Home Health Agency | $0 | $12.1M |
| Western Mass Home Health Services Inc | MA | Home Health Agency | $0 | $7.6M |
| Mitchell Clionsky | MA | Clinical Neuropsychologist | $294.4K | $0 |
| Colleen Calvanese | MA | Physical Therapist | $120.5K | $0 |
| Nicolas Cal | MA | Gastroenterology Physician | $91.1K | $11.4K |
| Ibelis Buzzetta | MA | Clinical Psychologist | $21.7K | $0 |
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