Loading...
NPI 1154722361 · Bend, OR · Substance Abuse Rehabilitation Facility
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Ortc, LLC is a substance abuse rehabilitation facility provider located in Bend, Oregon. This profile covers 7 Medicare and 23 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 | Ortc, LLC |
| Address | 155 Ne Revere Ave |
| City | Bend |
| State | OR |
| ZIP | 97701 |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| NPI Enumerated | September 7, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $16.2M |
| Medicare | $747.3K |
ORTC, LLC’s billing mix identifies it as an opioid treatment program (OTP) focused on medication-assisted treatment: Medicare revenue is dominated by G2067 (medication assisted treatment, methadone weekly bundle) which generated $639.4K and 2.7K claims (85.5% of the provider’s Medicare revenue), and Medicaid revenue is concentrated in S0109 (methadone, oral, 5 mg) and J0572 (buprenorphine/naloxone) which together represent the principal drug-dispensing activity on the Medicaid side. The presence of counseling, intake, and toxicology CPTs across both payers (e.g., H0016, H0004, H0048; and Medicare G2077/G2078) confirms a full-service OTP model that couples drug dispensing with behavioral and somatic supports. This profile is consistent with a facility focused on ongoing, weekly methadone dispensing plus buprenorphine treatment and associated counseling and testing workflows.
Revenue concentration is high on both payers: the precomputed top-three Medicare codes account for 96.3% of the provider’s total Medicare revenue, concentrating almost all Medicare payments in the OTP weekly bundle and its add-ons (G2067, G2077, G2078). Likewise, the precomputed top-three Medicaid codes account for 84.0% of Medicaid revenue, with S0109 alone representing $10.1M (62.4% of the provider’s Medicaid revenue). These concentrations indicate financial reliance on a narrow set of OTP drug- and service-codes rather than a broad mix of unrelated outpatient services.
ORTC’s payer mix is strongly Medicaid-weighted: lifetime Medicaid revenue of $16.2M dwarfs lifetime Medicare revenue of $747.3K, indicating the organization is effectively Medicaid-dominant in scale. Analysts should treat Medicare as a secondary revenue stream when modeling this entity’s financial exposure or network value, while Medicaid program rules and reimbursement levels will be the primary drivers of utilization and revenue risk.
Nationally for Medicare, the provider shows mixed competitive signals across OTP codes: G2077 (periodic assessment) ranks #4 of 352 providers nationally and is labeled notably above typical national volume (99th percentile), suggesting outsized activity in assessments or billing of that add-on. By contrast, G2067 ranks #50 of 830 (94th percentile) but is characterized here as typical, unremarkable volume, indicating that while the provider reports substantial weekly-bundle activity, it is not an extreme outlier on the primary bundle at a national level. Together these patterns suggest unusually high use of assessment add-ons relative to peers, though overall Medicare bundle volume is within common ranges for OTPs.
In-state competitive standing on Medicaid shows the provider is a leading but not monopolistic dispenser of opioid treatment: S0109 ranks #2 of 5 in-state (75th percentile) and J0572 ranks #3 of 13 (83rd percentile), reflecting sizable methadone and buprenorphine dispensing volumes (55.9K and 18.7K claims respectively) but with several in-state peers also active. H0016 (medical/somatic services) ranks #3 of 24 in-state at the 91st percentile and contributes $834.6K, indicating relatively strong provision of medical/somatic supports compared with other Oregon providers. Overall, ORTC is an important regional OTP provider but not the single dominant program statewide.
The provider’s service mix on Medicaid includes substantial ancillary OTP activities that align with comprehensive treatment operations: H0020 (methadone administration) appears with 47.6K claims and $951.8K, H0004 (behavioral counseling) produced $629.9K, and H0048 (drug testing collection) produced $224.7K, reflecting integrated dispensing plus counseling and testing workflows. On Medicare the presence of G2078 (take-home methadone supply) and G1028 (take-home naloxone) indicates take-home dispensing and harm-reduction components are billed as well, reinforcing that the business model extends beyond supervised dosing to include take-home medication and naloxone distribution. These code-level patterns support the characterization of ORTC as a full-service OTP combining medication, counseling, and monitoring.
ORTC has an established operating history, with its NPI enumerated 2014-09-07 (~12 years ago), which supports interpretation of these utilization patterns as built operational practice rather than a short-term anomaly. That tenure, combined with concentrated Medicaid volume ($16.2M lifetime) and recurring high-claim counts (e.g., 55.9K S0109 claims), suggests the provider maintains ongoing, steady-state OTP operations rather than episodic billing spikes.
There are notable billing/payment anomalies in the Medicaid line-level detail that warrant attention as administrative or payer-specific coding patterns rather than clinical conclusions: several OTP add-on codes show claims but zero average paid amounts on Medicaid (e.g., G2077: 711 claims, $0 avg paid/claim, $0 revenue; G2078 and G1028 also list $0 average paid), while G2067 appears on Medicaid with 8.5K claims but $1 avg paid/claim ($8.5K revenue). These entries may reflect carve-outs, bundled payment adjustments, or claim-level adjudication rules in-state and should be validated against contract-level reimbursement policies when assessing revenue realization and claim adjudication behavior.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 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… | 2,740 | $230 | $639.4K |
| 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… | 470 | $110 | $53.6K |
| 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 | 700 | $40 | $27.2K |
| 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… | 70 | $180 | $12.8K |
| 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… | 40 | $190 | $6.7K |
| G2080 | Each additional 30 minutes of counseling in a week of medication assisted treatment, (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code… | 200 | $30 | $6.2K |
| G1028 | Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary… | 20 | $130 | $2.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
23 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| S0109 | Methadone, oral, 5 mg | 55,870 | $180 | $10.1M |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 18,700 | $140 | $2.5M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 47,590 | $20 | $951.8K |
| H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | 9,590 | $90 | $834.6K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 12,860 | $50 | $629.9K |
| J3490 | Unclassified drugs | 6,770 | $60 | $392.5K |
| H0033 | Oral medication administration, direct observation | 11,890 | $20 | $261.6K |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 17,280 | $10 | $224.7K |
| H0001 | Alcohol and/or drug assessment | 930 | $150 | $142.9K |
| H0006 | Alcohol and/or drug services; case management | 2,670 | $20 | $53.4K |
Showing 1–10 of 23
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
23 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| S0109 | Methadone, oral, 5 mg | 2 | 10 | 47,840 | $130 | $5.4M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 21 | 30 | 86,800 | $10 | $2.4M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 38 | 270 | 1,660 | $90 | $681K |
| H0033 | Oral medication administration, direct observation | 7 | 20 | 4,620 | $10 | $521.2K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 3 | 10 | 4,600 | $20 | $309.8K |
| H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | 3 | 20 | 1,840 | $70 | $256.9K |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 28 | 160 | 2,750 | $20 | $205.1K |
| H0001 | Alcohol and/or drug assessment | 11 | 100 | 80 | $140 | $70.6K |
| H0032 | Mental health service plan development by non-physician | 72 | 190 | 80 | $100 | $52.2K |
| H0006 | Alcohol and/or drug services; case management | 21 | 100 | 380 | $30 | $51.1K |
Showing 1–10 of 23
Other providers in the same ZIP code as Ortc, LLC, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.