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NPI 1053319368 · Woonsocket, RI · Methadone Clinic
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R.i.s.a.t., LLC is a methadone clinic provider located in Woonsocket, Rhode Island. This profile covers 4 Medicare and 15 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 | R.i.s.a.t., LLC |
| Address | 1625 Diamond Hill Rd |
| City | Woonsocket |
| State | RI |
| ZIP | 02895 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | July 11, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $21.6M |
| Medicare | $306K |
This provider is heavily Medicaid-focused: lifetime Medicaid revenue is $21.6M versus total Medicare revenue of $306K, making Medicaid the dominant payer by scale and effectively the primary commercial channel for its services. The disparity in dollar volume suggests the organization operates largely within state behavioral health and substance-use funding streams rather than relying on Medicare.
Revenue is highly concentrated around a few codes on both payers: the top 3 Medicare codes account for 98.7% of Medicare revenue (driven by G2067, G2078, G2074) and the top 3 Medicaid codes account for 93.9% of Medicaid revenue (driven by H0020, H0047, G2067). This concentration indicates the business is focused on a narrow set of bundled opioid treatment program services rather than a broad mix of unrelated clinical lines.
The code mix and code descriptions identify R.I.S.A.T., LLC as a methadone-focused opioid treatment program: heavy billing for H0020 (methadone administration), G2067 and G2074 (weekly medication assisted treatment bundles) and G2078 (take-home methadone supplies) point to on-site dispensing plus bundled counseling, toxicology testing, and therapy. The prominence of these OTP-specific bundles suggests routine delivery of both medication dispensing and integrated psychosocial services.
Within Rhode Island Medicaid the provider appears to be a dominant in-state methadone administrator: H0020 is listed as 545.9K claims, $14.7M revenue and ranks #1 of 31 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). Complementary Medicaid positions — H0047 at rank #3 of 22 (90th percentile) and G2067 at rank #2 of 13 (92th percentile) — reinforce a strong statewide footprint for both medication delivery and broader AOD services.
By contrast, the provider’s Medicare standing is modest at a national level: G2067 generates $265K (86.6% of the provider’s Medicare revenue) but ranks #214 of 830 providers nationally (74th percentile) and supporting Medicare codes (G2078, G2074) also sit at middling percentiles. These rank/percentile patterns indicate typical, unremarkable national Medicare volume for OTP bundles rather than a market-leading role on the Medicare side.
Beyond dispensing bundles, the billing mix shows substantial behavioral-health service lines billed to Medicaid: H0047 has 15.2K claims and $3.5M revenue, 90832 reports 3.9K claims and $116.6K revenue, and 90853 reports 2.2K claims and $60K revenue. These psychotherapy, group therapy, and AOD-service codes demonstrate the provider delivers counseling and group modalities that complement methadone treatment rather than operating solely as a drug-dispensing clinic.
There is a notable pattern of high-volume Medicaid claims with $0 average paid amounts for certain supportive codes: H0006 shows 49.2K claims with $0 avg paid/claim and H0036 shows 7.6K claims with $0 avg paid/claim. This billing pattern is data-grounded and suggests frequent submission of encounter, case-management, or per-unit supportive-service claims that do not show payment in the dataset and may reflect programmatic reporting or non-fee payment structures within state Medicaid.
R.I.S.A.T., LLC has long tenure in the Medicare/Medicaid system, with its NPI enumerated on 2005-07-11 (~21 years ago), consistent with an established outpatient opioid treatment program. Combined with the provider’s Medicaid scale and in-state outlier status on H0020, the data indicate an entrenched operational position in Rhode Island’s methadone treatment market.
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… | 1,100 | $240 | $265K |
| 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 | 620 | $40 | $23.6K |
| 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… | 70 | $200 | $13.6K |
| 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 | $3.9K |
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.
15 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) | 545,910 | $30 | $14.7M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 15,200 | $230 | $3.5M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 15,530 | $130 | $2.1M |
| H0037 | Community psychiatric supportive treatment program, per diem | 4,230 | $200 | $841.8K |
| 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 | 4,420 | $30 | $145.7K |
| 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… | 3,890 | $30 | $116.6K |
| 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… | 590 | $130 | $75.9K |
| 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… | 2,220 | $30 | $60K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 1,480 | $30 | $41.3K |
| 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… | 150 | $90 | $12.8K |
Showing 1–10 of 15
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
15 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 | 30 | 12,240 | $50 | $3.9M |
| H0037 | Community psychiatric supportive treatment program, per diem | 15 | 70 | 190 | $380 | $3.2M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 3 | 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… | 2 | 10 | 680 | $130 | $651.1K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 25 | 80 | 340 | $70 | $223.7K |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 12 | 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… | 497 | 750 | 330 | $70 | $92.5K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 4 | 10 | 530 | $70 | $84.5K |
| 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… | 1,196 | 2,050 | 300 | $50 | $72.3K |
| 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… | 13 | 190 | 270 | $40 | $51K |
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Other providers in the same ZIP code as R.i.s.a.t., LLC, ranked by combined Medicare and Medicaid revenue.
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