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NPI 1053474213 · Pawtucket, RI · Community/Behavioral Health Agency
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Addiction Recovery Institute is a community/behavioral health agency provider located in Pawtucket, Rhode Island. This profile covers 2 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 | Addiction Recovery Institute |
| Address | 31 N Union St |
| City | Pawtucket |
| State | RI |
| ZIP | 02860 |
| Taxonomy | Community/Behavioral Health Agency |
| NPI Enumerated | December 19, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $15.4M |
| Medicare | $180.1K |
ADDICTION RECOVERY INSTITUTE’s code mix shows it operates primarily as an opioid treatment program and community behavioral health agency: large volumes on methadone-focused codes (G2067 and H0020) and secondary codes for take-home dosing and general AOD services indicate the organization provides medication-assisted treatment alongside counseling, group therapy, and toxicology testing typical of licensed methadone programs. The presence of both G2067 on Medicare and H0020/H0047 on Medicaid points to an operational focus on substance use disorder treatment rather than general primary care.
Revenue concentration on Medicare is extremely narrow: the precomputed top-3 Medicare codes account for 100.0% of the provider’s Medicare revenue, with G2067 alone generating $167.5K (92.8% of Medicare revenue) and G2078 contributing $13.1K (7.2%). This shows Medicare receipts are almost entirely driven by bundled methadone-treatment services rather than a diversified set of evaluation-and-management or psychotherapy codes.
On the Medicaid side the provider is effectively a Medicaid-centric operation: total Medicaid revenue is $15.4M versus total Medicare revenue of $180.1K, making Medicaid the dominant payer by scale. The top three Medicaid codes account for 94.0% of Medicaid revenue, underlining that a few SUD-related services drive nearly all payer receipts on the Medicaid side.
Medicaid revenue is heavily concentrated in a single procedure class: H0020 (methadone administration) represents $10.8M and 300.5K claims (70.1% of Medicaid revenue), with H0047 at $2.7M (17.7%) and G2067 at $970K (6.3%). The extremely large H0020 claim count signals high throughput for medication dispensing/administration; combined these three codes constitute the majority of Medicaid billing and underscore operational reliance on ongoing dosing services.
Competitive standing differs by payer and code. Nationally on Medicare the provider is a modest participant—G2067 ranks #324 of 830 (61th percentile) and G2078 ranks #257 of 493 (48th percentile), both characterized in the source as "typical, unremarkable volume for this code." In contrast, the provider is a leading in-state Medicaid performer for methadone and related services: H0020 ranks #4 of 31 in-state (90th percentile), H0047 ranks #5 of 22 (81th percentile), and Medicaid G2067 ranks #3 of 13 (83th percentile), indicating above-typical market position within Rhode Island for key SUD treatment codes.
Several billed codes report non‑zero claim counts but $0 average paid/claim and $0 revenue (for example H0006: 14.9K claims, $0 avg paid/claim, $0 revenue; H0036: 5.8K claims, $0 avg paid/claim, $0 revenue). These zero-paid tallies often reflect bundled payments, encounter reporting, or administrative/state-specific reimbursement mechanics rather than delivery-volume absence, and they merit attention when reconciling encounter counts to paid revenue.
The provider has long tenure in national enrollment (NPI enumerated 2006-12-19, ~20 years ago), which combined with sustained high Medicaid volumes—particularly 300.5K H0020 claims—suggests an established, ongoing capacity for opioid treatment services rather than a new or sporadic program. This longevity supports interpretation of the billing pattern as operational scale rather than a transient spike.
Beyond methadone dispensing, the billing mix includes community psychiatric supportive treatment and routine outpatient behavioral visits, indicating some breadth of services: H0037 (per diem community psychiatric supportive treatment) produced $909.4K (5.9% of Medicaid revenue), and smaller volumes for 99213 ($7.8K) and 90834 ($5.3K) show office/outpatient evaluation and psychotherapy are part of the service set. These secondary codes suggest the provider pairs medication-assisted treatment with wraparound behavioral-health supports at lower revenue levels compared with dosing services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
2 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… | 790 | $210 | $167.5K |
| 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 | 360 | $40 | $13.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 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) | 300,490 | $40 | $10.8M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 12,190 | $220 | $2.7M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 7,130 | $140 | $970K |
| H0037 | Community psychiatric supportive treatment program, per diem | 4,500 | $200 | $909.4K |
| 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… | 150 | $50 | $7.8K |
| 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… | 70 | $80 | $5.3K |
| H0006 | Alcohol and/or drug services; case management | 14,930 | $0 | $0 |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 5,750 | $0 | $0 |
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
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) | 4 | 30 | 12,240 | $50 | $3.9M |
| H0037 | Community psychiatric supportive treatment program, per diem | 13 | 70 | 190 | $380 | $3.2M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 5 | 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… | 3 | 10 | 680 | $130 | $651.1K |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 15 | 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… | 599 | 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… | 1,283 | 2,050 | 300 | $50 | $72.3K |
| H0006 | Alcohol and/or drug services; case management | 7 | 30 | 940 | $0 | $0 |
Other providers in the same ZIP code as Addiction Recovery Institute, ranked by combined Medicare and Medicaid revenue.
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