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 Connecticut for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Connecticut 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. Connecticut (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.

Apt Foundation, Inc (NPI 1073679445)

Field	Value
Entity Type	Organization
Organization	Apt Foundation, Inc
Address	352 State St
City	North Haven
State	CT
ZIP	06473
Taxonomy	Methadone Clinic
NPI Enumerated	December 29, 2006

Payer Source	Total Paid
Medicaid	$36.6M
Medicare	$0

Key Findings

Payer mix and scale: This provider has no Medicare billing on file (Medicare revenue: none) and reports $36.6M in lifetime Medicaid revenue, indicating it is effectively a Medicaid-focused provider. The NPI was enumerated 2006-12-29 (~20 years ago), reflecting an established presence in the market rather than a recent entrant.

Revenue concentration: Medicaid revenue is highly concentrated — the precomputed top-3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, and H0020 alone is reported at $36.6M (2.6M claims, $14 avg paid/claim), representing 100.0% of the provider's Medicaid revenue. This concentration means a single service line drives virtually all payer dollars recorded here.

Business/service-line implications: The dominant code H0020 (methadone administration/provision) indicates the organization operates primarily as a medication-assisted treatment (methadone clinic) delivering on-site drug provision and administration. The code mix — heavy on methadone administration with large supporting volumes of drug screens and psychotherapy encounters recorded — lines up with an outpatient opioid use disorder treatment model.

Competitive standing on the principal service: For H0020 this provider ranks #2 of 25 in-state and sits in the 96th percentile, which places it among the larger in-state providers for methadone administration. Despite the high rank, the file characterizes the volume for this code as “typical, unremarkable,” suggesting that while the provider is a top in-state performer numerically, H0020 reimbursements may follow standard per-encounter patterns for this service.

High-volume, zero-revenue screening activity: Code 80305 shows 61.1K claims with $0 avg paid/claim and $0 revenue and ranks #1 of 75 in-state (100th percentile; labeled an “extreme outlier, far above typical state volume”). This indicates an exceptionally large volume of recorded presumptive drug tests that do not contribute to reported Medicaid revenue for this provider.

Psychotherapy and related encounter volume with no reported Medicaid revenue: Codes 90832 (50.1K claims, $0 revenue; rank #18 of 417, 96th percentile, “typical, unremarkable”), 90853 (42.6K claims, $0 revenue; rank #15 of 300, 95th percentile, “notably above typical”), 98967 (1.6K claims, $0 revenue; rank #8 of 126, 94th percentile), and 90834 (397 claims, $0 revenue; rank #291 of 571, 49th percentile) show substantial claim counts but report $0 Medicaid revenue. The pattern suggests many counseling/group/telephonic encounters are recorded on claims that, in this dataset, are not generating Medicaid-paid dollars for this provider.

Claims vs. revenue mismatch and operational interpretation: Across multiple codes the provider records very large claim volumes while Medicaid revenue is almost entirely concentrated in H0020. This mismatch is a clear, data-grounded signal that administrative or billing structure (e.g., medication administration as the reimbursed line item versus zero-paid screening or counseling claim lines) dominates how Medicaid dollars are realized here, and should be evaluated by analysts when assessing utilization versus paid-revenue exposure.

Market and contracting implication: Given the near-exclusive Medicaid revenue ($36.6M) and long tenure (NPI enumerated 2006-12-29 (~20 years ago)), payers should view APT FOUNDATION, INC as an established methadone treatment provider with significant Medicaid exposure and high throughput of ancillary services. Network decisions or payment-model adjustments should account for the fact that H0020 drives the financial relationship, while many other high-volume activities appear on the claims ledger without corresponding Medicaid payments.

Medicaid: Complete Services Breakdown

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

6 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)	2,617,730	$10	$36.6M
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…	61,140	$0	$0
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…	50,090	$0	$0
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…	400	$0	$0
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…	42,610	$0	$0
98967	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	1,550	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Apt Foundation, Inc — 1 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

6 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)	2	30	668,110	$10	$15.3M
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…	18	420	1,230	$20	$199.3K
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…	291	570	410	$50	$197.6K
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…	15	300	2,660	$20	$181.1K
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…	1	80	790	$1	$12.1K
98967	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	8	130	150	$20	$10.5K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Apt Foundation, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apt Foundation, Inc	CT	Methadone Clinic	$0	$28.6M
Apt Foundation Inc.	CT	Methadone Clinic	$0	$21.6M
Apt Foundation Inc	CT	Methadone Clinic	$1.2M	$11.6M
Apt Foundation, Inc	CT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$2.3M
Apt Foundation, Inc	CT	Methadone Clinic	$0	$1.8M
Apt Foundation, Inc	CT	Clinic/Center	$0	$1.3M
Michael Tawiah	CT	Family Nurse Practitioner	$27.3K	$0

Nearby Providers

Other providers in the same ZIP code as Apt Foundation, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Efk Of Connecticut, Inc.	CT	Land Ambulance	$2.2M	$9.1M
Epic Family Physicians, LLP	CT	Family Medicine Physician	$0	$7.9M
Family Practice & Internal Medicine, LLC	CT	Internal Medicine Physician	$0	$6.9M
Pediatrics Plus PC	CT	Pediatric Nurse Practitioner	$0	$2.2M
Mindful Mediation LLC	CT	Clinical Social Worker	$0	$1.7M
Interim Healthcare Of North Haven, Inc.	CT	Home Health Agency	$0	$1.7M
Complete Pediatrics	CT	Pediatric Adolescent Medicine Physician	$0	$1.6M
Pediatrics Plus PC	CT	Pediatrics Physician	$0	$1.1M
Art Therapy Of Hamden LLC	CT	Professional Counselor	$0	$1.1M
Peoples Home Healthcare Inc	CT	Oxygen Equipment & Supplies (DME)	$0	$1.1M

Apt Foundation, Inc — Billing Profile & Reimbursement Data

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Apt Foundation, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References