Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Rhode Island for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Rhode Island only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Rhode Island (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

The Journey To Hope, Health & Healing, Inc (NPI 1033259478)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Journey To Hope, Health & Healing, Inc
Address	985 Plainfield Street
City	Johnston
State	RI
ZIP	02919
Taxonomy	Methadone Clinic
NPI Enumerated	February 7, 2007

Payer Source	Total Paid
Medicaid	$16.8M
Medicare	$0

THE JOURNEY TO HOPE, HEALTH & HEALING, INC is effectively a single-payer Medicaid-funded methadone clinic with no Medicare billing on file; lifetime Medicaid revenue is $16.8M and total Medicare revenue is listed as none, indicating the organization’s revenue and clinical activity are concentrated in state Medicaid programs rather than Medicare. The provider’s NPI was enumerated on 2007-02-07 (~19 years ago), showing long-standing enrollment and operational tenure in the community.

Revenue is highly concentrated in a small set of Medicaid procedure lines: the top three Medicaid codes (H0020, H0047, H0037) together account for 99.3% of the provider’s total Medicaid revenue, demonstrating dependence on a narrow service mix dominated by methadone administration and related substance-use services. This concentration implies limited service diversification outside core opioid treatment programming.

H0020 (methadone administration/service) is the single largest revenue driver with $11.4M in Medicaid revenue (68.0% of the provider’s Medicaid receipts), and the provider ranks #6 of 31 in-state (83rd percentile). This rank places the organization above the median among Rhode Island methadone/OTP providers for this code, indicating solid operational scale in dispensing methadone but not outright dominance statewide.

H0047 (other alcohol and/or drug abuse services) contributes $4.1M (24.4% of Medicaid revenue) and the provider ranks #2 of 22 in-state (95th percentile). That high percentile for H0047 suggests the clinic is a leading in-state provider of broader substance-use treatment services beyond methadone dispensing, reinforcing a business model that bundles counseling or non-specific AOD services with medication treatment.

H0037 (community psychiatric supportive treatment, per diem) accounts for $1.2M (6.9% of Medicaid revenue) and ranks #11 of 69 providers in-state (85th percentile). The presence and ranking on H0037 indicate the clinic also provides per-diem community psychiatric support services at a higher-than-average in-state position, consistent with integrated behavioral health supports alongside medication-assisted treatment.

Across ancillary codes, the provider reports modest volumes of E/M and psychotherapy codes (e.g., 99213 $66.9K; 90834 $34.4K) that together represent very small shares of overall Medicaid revenue. These lower-revenue, higher-frequency ambulatory and psychotherapy services suggest some outpatient/clinical encounters occur within the organization but are not major revenue drivers compared with methadone and core AOD program codes.

Several billed codes show $0 average paid/claim or $0 revenue in the dataset (e.g., H0036, G2067, H0006, 80305), which may reflect reporting artifacts, bundled payments, or claims processed outside fee-for-service lines rather than meaningful service absence; analysts should treat those zero-dollar lines cautiously and validate with encounter-level or contract data before assuming no related activity.

Given the provider’s focused Medicaid-only revenue profile, high concentration in H0020 and H0047, and long NPI tenure (~19 years), the business profile aligns with a mature opioid treatment program that centers methadone dispensing and allied AOD counseling services as its primary operations. From a payer or competitor perspective, the clinic is an established, above-median in-state participant for its top Medicaid service lines but not the statewide market leader for methadone administration.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

12 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)	167,980	$70	$11.4M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	18,560	$220	$4.1M
H0037	Community psychiatric supportive treatment program, per diem	5,260	$220	$1.2M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	1,490	$50	$66.9K
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…	480	$70	$34.4K
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…	330	$30	$10.8K
90832	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…	2,500	$1	$5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	20	$100	$1.9K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	40	$0	$0
G2067	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…	680	$0	$0

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

Claims Volume vs. Rhode Island Distribution

The Journey To Hope, Health & Healing, Inc — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

12 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)	6	30	12,240	$50	$3.9M
H0037	Community psychiatric supportive treatment program, per diem	11	70	190	$380	$3.2M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	2	20	1,280	$220	$1.6M
G2067	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…	7	10	680	$130	$651.1K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	36	90	510	$10	$187.5K
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…	311	750	330	$70	$92.5K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	385	2,050	300	$50	$72.3K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	121	160	50	$150	$59.2K
90832	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…	21	190	270	$40	$51K
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…	32	100	130	$30	$25.6K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Comfort LLC	RI	Home Health Agency	$0	$18.7M
Tri-county Community Action Agency	RI	Federally Qualified Health Center (FQHC)	$0	$7.4M
Absolute Respiratory Care LLC	RI	Oxygen Equipment & Supplies (DME)	$0	$6.4M
Ocean State Behavioral Health, LLC	RI	Substance Use Disorder Rehabilitation Clinic/Center	$0	$5.6M
Fredrick Mcmillen	RI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.9M
Svetlo Inc	RI	Adult Day Care Clinic/Center	$0	$4.8M
Maulik Kotdawala	RI	General Practice Dentistry	$0	$4.6M
Barrett Nordstrom	RI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.9M
Atmed Treatment Center, Inc.	RI	Internal Medicine Physician	$0	$3.1M
The Autism Project	RI	Voluntary or Charitable Agency	$0	$3.1M

The Journey To Hope, Health & Healing, Inc — Billing Profile & Reimbursement Data

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The Journey To Hope, Health & Healing, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References