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 1144386442)

Field	Value
Entity Type	Organization
Organization	Apt Foundation, Inc
Address	495 Congress Ave
City	New Haven
State	CT
ZIP	06519
Taxonomy	Methadone Clinic
NPI Enumerated	December 29, 2006

Payer Source	Total Paid
Medicaid	$28.6M
Medicare	$0

Key Findings

APT FOUNDATION, INC reports $28.6M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single-payer (Medicaid) operation in the datasets provided. The precomputed top-3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, indicating extreme revenue concentration around a narrow set of services rather than a diversified payer mix.

The Medicaid revenue picture is dominated by H0020: 2M claims at $14 avg paid/claim producing $28.6M in revenue, which matches the provider’s Methadone Clinic taxonomy and identifies medication-assisted opioid treatment (methadone administration/provision) as the core revenue-driving service line. This concentration on H0020 signals the organization’s primary business model is licensed-program methadone administration rather than broad medical or surgical services.

Competitive standing on the principal revenue code places the provider as one of the larger in-state billers for methadone administration: H0020 ranks #3 of 25 providers in-state (92th percentile). While that rank indicates a leading position by count, the dataset characterizes the volume as "typical, unremarkable," suggesting other sizeable in-state programs also generate comparable billing for H0020.

Claim-level activity shows a broader service footprint beyond pure revenue drivers: psychotherapy and group therapy codes appear frequently in claims (90832 at 69.2K claims and 90853 at 29.1K claims) but display $0 avg paid/claim and $0 recorded revenue in this extract. The presence of these high-count psychotherapy codes implies the clinic documents counseling and group therapy encounters alongside medication services, even though they do not contribute to the Medicaid revenue total shown here.

Laboratory and monitoring activity is notable in volume but not in paid revenue: 80305 appears with 48.8K claims and is labeled an "extreme outlier, far above typical state volume" (rank #2 of 75, 99th percentile), yet it shows $0 avg paid/claim and $0 revenue. This indicates very high documented screening/drug-testing throughput in claims data that is not reflected as paid Medicaid revenue in the supplied payment fields.

Several psychotherapy codes rank highly in statewide percentiles even without recorded revenue: 90832 ranks #11 of 417 (98th percentile, described as "notably above typical"), and 90853 ranks #24 of 300 (92th percentile, "typical, unremarkable"). These high-percentile ranks for non-revenue psychotherapy entries underscore a service mix that includes frequent counseling/group therapy as part of the clinic’s operations, reinforcing a combined medication-plus-counseling model.

Operational cadence implied by the claims counts supports a frequent-contact treatment model: 2M H0020 claims and tens of thousands of psychotherapy and drug-test claims suggest recurring, regular patient encounters consistent with ongoing methadone program workflows. The combination of very high claim volumes and a singular revenue driver (H0020) points to an organization whose day-to-day activity centers on routine dispensing and related monitoring/counseling visits.

The provider’s NPI was enumerated on 2006-12-29 (~20 years ago), indicating long tenure in the market. Coupled with the $28.6M Medicaid revenue and high claim volumes for treatment, this longevity and billing footprint suggest an established, operationally mature methadone-treatment provider within Connecticut’s Medicaid system.

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)	2,045,120	$10	$28.6M
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…	48,800	$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…	69,240	$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…	1,060	$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…	29,050	$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…	410	$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 — 0 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)	3	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…	11	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…	207	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…	24	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…	2	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…	31	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	$36.6M
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
Cornell Scott Hill Health Corporation	CT	Federally Qualified Health Center (FQHC)	$338.5K	$294.2M
Yale Univ School Of Medicine	CT	Adolescent and Children Mental Health Clinic/Center	$0	$13.2M
New Haven Board Of Education	CT	Local Education Agency (LEA)	$0	$12.2M
Connecticut Retina Consultants LLC	CT	Ophthalmology Physician	$0	$8.3M
Continuum Of Care, Inc.	CT	Adult Mental Health Clinic/Center	$0	$4.9M
Connecticut Pulmonary Specialists, PC	CT	Pulmonary Disease Physician	$0	$2.3M
Wayne Larrison	CT	Ophthalmology Physician	$1.9M	$0
Rachel Collins	CT	Professional Counselor	$0	$1.7M
James Weisz	CT	Ophthalmology Physician	$1.3M	$0
Amir Cohen	CT	Ophthalmology Physician	$1.1M	$0

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