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NPI 1033629100 · West Lebanon, NH · Methadone Clinic
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Habit Opco, LLC is a methadone clinic provider located in West Lebanon, New Hampshire. This profile covers 4 Medicare and 8 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 | 254 Plainfield Rd |
| City | West Lebanon |
| State | NH |
| ZIP | 03784 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | October 3, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3.9M |
| Medicare | $493.3K |
HABIT OPCO, LLC is operating as a methadone clinic/OTP: the billing mix is dominated by medication-assisted treatment and methadone administration codes (notably G2067 and H0020) plus associated counseling codes, which indicates the organization primarily provides daily/weekly methadone dispensing together with bundled counseling and toxicology services rather than a broad spectrum of general medical services. The provider’s taxonomy (Methadone Clinic) and the presence of both G2067 and H0020 at the top of payer revenue lists support a core operational focus on opioid use disorder treatment delivery.
Revenue is highly concentrated by a very small set of codes on both payers: the top 3 Medicare codes account for 99.6% of the provider’s total Medicare revenue and the top 3 Medicaid codes account for 98.9% of total Medicaid revenue. On Medicare this concentration is driven by G2067 (89.0% of Medicare revenue) with G2078 (9.9%) and G2077 (0.7%) rounding out the mix; on Medicaid the concentration is driven by H0020 (77.6% of Medicaid revenue), G2067 (19.7%), and H0005 (1.7%).
The provider is substantially Medicaid-weighted: lifetime Medicare revenue is $493.3K while lifetime Medicaid revenue is $3.9M, so Medicaid represents the dominant payer by scale. This indicates the clinic’s case-mix and financial exposure are concentrated in state Medicaid reimbursement and policies rather than Medicare.
Competitive standing for the provider’s signature Medicare code G2067 is mixed: G2067 represents $439.1K (1.8K claims) and is 89.0% of the provider’s Medicare revenue while it ranks #91 of 830 nationally (89th percentile); the dataset’s plain-English label for that ranking is "typical, unremarkable volume for this code," which suggests the provider has a meaningful share of its own Medicare revenue tied to G2067 but is not an extreme outlier at the national level. The secondary Medicare code G2078 ($48.7K; 1.3K claims) ranks #31 of 493 (94th percentile) and is also described as "typical, unremarkable volume for this code," indicating comparable national standing for its take-home billing activity under Medicare.
State-level competitive standing on Medicaid is modest: H0020 (77.6% of Medicaid revenue, $3M, 77.4K claims) ranks #7 of 9 in-state (25th percentile) and is labeled "typical, unremarkable volume for this code," signaling that while H0020 drives most Medicaid revenue for this clinic, the provider sits below many in-state peers on absolute volume. The paired Medicaid G2067 revenue ($766.1K; 7.4K claims) ranks #7 of 8 in-state (14th percentile) and likewise carries the "typical, unremarkable volume for this code" label, reinforcing that the clinic is a modest state participant rather than a dominant statewide operator.
Operational detail from claim counts underscores how services are delivered: Medicaid H0020 shows 77.4K claims and $3M revenue, indicating a very high frequency of dispensing-style transactions billed under methadone administration, while Medicaid G2067 shows 7.4K claims and $766.1K revenue suggesting regular use of the bundled weekly medication-assisted treatment payment. Together these volumes imply the clinic’s day-to-day activity is centered on frequent dispensing (H0020) with a secondary stream for bundled weekly care (G2067), consistent with an OTP that dispenses medication daily and bills weekly bundles for comprehensive services.
There is limited use of periodic assessment and take-home billing on Medicaid relative to peers: Medicaid G2078 has only 142 claims for $5.1K and is described as "notably below typical state volume for this code," and G2077/G2074 also appear at very low absolute volumes. This pattern could reflect fewer approved take-home supplies or less frequent billing of periodic assessments for Medicaid patients compared with in-state peers, which may have operational or policy implications for patient dosing schedules, retention strategies, or state authorization of take-home privileges.
The provider’s NPI was enumerated on 2017-10-03 (~9 years ago), establishing nearly a decade of billing history; given that tenure and the concentrated payer/code profile, stakeholders evaluating network participation or contracting should regard HABIT OPCO, LLC as an established, Medicaid-focused methadone treatment provider with concentrated revenue streams and modest in-state competitive positioning.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 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… | 1,810 | $240 | $439.1K |
| 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 | 1,280 | $40 | $48.7K |
| 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… | 30 | $120 | $3.4K |
| 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… | 10 | $160 | $2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
8 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) | 77,380 | $40 | $3M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 7,370 | $100 | $766.1K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 2,840 | $20 | $65.3K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 590 | $50 | $29.9K |
| 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 | 140 | $40 | $5.1K |
| 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… | 40 | $80 | $3.2K |
| 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… | 20 | $90 | $2K |
| H0001 | Alcohol and/or drug assessment | 10 | $150 | $2K |
How this provider's Medicaid billing volume and revenue compare to other New Hampshire providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Hampshire median
8 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) | 7 | 10 | 331,430 | $10 | $5.1M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 7 | 10 | 9,800 | $110 | $1.4M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 43 | 70 | 1,260 | $80 | $202.1K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 6 | 30 | 340 | $20 | $72.6K |
| H0001 | Alcohol and/or drug assessment | 41 | 40 | 180 | $130 | $71.5K |
| 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 | 8 | 10 | 1,820 | $40 | $61.3K |
| 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… | 7 | 10 | 250 | $70 | $27.5K |
| 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… | 8 | 10 | 400 | $40 | $14.3K |
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 |
|---|---|---|---|---|
| Upper Valley Pediatric Dentistry, PC | NH | Preferred Provider Organization | $0 | $1.2M |
| Foad Rasekh | NH | General Practice Dentistry | $0 | $679.4K |
| Prime Anesthesia PLLC | NH | Certified Registered Nurse Anesthetist | $0 | $464.5K |
| Family Health Center, P.A. | NH | Family Medicine Physician | $0 | $275.4K |
| Walgreen Co | NH | Pharmacy | $245K | $0 |
| James Kelsey | NH | Family Medicine Physician | $166.6K | $0 |
| Maxi Drug North Inc | NH | Community/Retail Pharmacy | $156.6K | $0 |
| Cvs Manchester Nh L.L.C. | NH | Pharmacy | $132.1K | $0 |
| Wal-mart Stores East LP | NH | Community/Retail Pharmacy | $93.1K | $0 |
| Jessica Eid | NH | Optometrist | $52.6K | $0 |
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