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NPI 1174521488 · Providence, RI · Methadone Clinic
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R.i.s.a.t., LLC is a methadone clinic provider located in Providence, 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 | 66 Pavilion Ave |
| City | Providence |
| State | RI |
| ZIP | 02905 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | July 11, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $14M |
| Medicare | $321.1K |
R.I.S.A.T., LLC operates as an opioid treatment/methadone clinic based on its dominant codes: Medicare claims are driven by OTP weekly bundles and take-home methadone (G2067, G2074, G2078), while Medicaid activity is concentrated in methadone administration and broader alcohol/drug services (H0020, H0047, H0037). The code mix points to a service model centered on medication‑assisted treatment with integrated counseling, group therapy, toxicology testing, and periodic assessments rather than a general medical outpatient practice.
Revenue concentration is extremely high on both payers: the top 3 Medicare codes by revenue account for 98.1% of this provider's total Medicare revenue, with G2067 alone representing 73.7% of Medicare revenue, G2074 17.5%, and G2078 6.8%. This indicates the provider’s Medicare income is almost entirely derived from OTP weekly bundles and associated add‑ons.
On Medicaid the top 3 codes by revenue account for 98.2% of total Medicaid revenue, dominated by H0020 (66.5%), H0047 (23.3%), and H0037 (8.4%). These shares show Medicaid revenue is overwhelmingly concentrated in methadone administration and related AOD support services, implying operational scale focused on dispensing and programmatic services billed to Medicaid.
Payer mix is heavily skewed toward Medicaid: Total Medicare revenue is $321.1K versus Total Medicaid revenue of $14M, so the organization is effectively Medicaid‑dominant in scale and financial exposure. Medicare exists as a much smaller revenue stream and appears to be a secondary payer relative to Medicaid for this clinic.
Competitive standing on Medicare is mixed: G2067 ranks #246 of 830 providers nationally (70th percentile) and is described as typical/unremarkable volume, while G2074 is relatively strong nationally at rank #19 of 179 (90th percentile). Overall, Medicare volumes are serviceable but not nationally dominant, with one Medicare OTP bundle code (G2074) showing above‑typical standing.
In-state Medicaid positioning is materially stronger: H0020 ranks #5 of 31 providers in-state (87th percentile), H0047 ranks #4 of 22 (86th percentile), and H0037 ranks #9 of 69 (88th percentile). These ranks and percentiles characterize R.I.S.A.T. as a leading in-state provider for methadone administration and associated substance‑use services rather than a marginal competitor.
There are notable reimbursement patterns in Medicaid billing: several high‑volume Medicaid codes report $0 average paid/claim and therefore $0 revenue (H0006: 33.6K claims $0 revenue; H0036: 15.1K claims $0 revenue; G2078: 632 claims $0 revenue; G2074: 35 claims $0 revenue). These zero‑dollar lines suggest encounter reporting, non‑billable/service tracking, bundled reimbursement outside fee‑for‑service, or adjudication outcomes that eliminate paid amounts and should be reviewed when interpreting gross claim counts versus collected revenue.
The provider’s NPI was enumerated on 2005-07-11 (~21 years ago), indicating long tenure in the market. Combined with sustained, large Medicaid volumes (e.g., 274K claims for H0020 and 14.3K claims for H0047) this tenure supports a conclusion of an established methadone clinic with durable payer relationships and high dispensing throughput.
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… | 970 | $240 | $236.9K |
| 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… | 290 | $200 | $56.3K |
| 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 | 580 | $40 | $22K |
| 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… | 50 | $120 | $6.2K |
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) | 273,980 | $30 | $9.3M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 14,270 | $230 | $3.3M |
| H0037 | Community psychiatric supportive treatment program, per diem | 5,890 | $200 | $1.2M |
| 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… | 3,130 | $50 | $150.3K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 3,450 | $10 | $31K |
| 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… | 340 | $80 | $26.1K |
| 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… | 490 | $40 | $20.6K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 270 | $50 | $13.8K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 110 | $50 | $5.4K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 70 | $50 | $3.6K |
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) | 5 | 30 | 12,240 | $50 | $3.9M |
| H0037 | Community psychiatric supportive treatment program, per diem | 9 | 70 | 190 | $380 | $3.2M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 4 | 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… | 5 | 10 | 680 | $130 | $651.1K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 45 | 80 | 340 | $70 | $223.7K |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 11 | 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… | 372 | 750 | 330 | $70 | $92.5K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 250 | 360 | 280 | $90 | $86.4K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 1,220 | 1,730 | 220 | $70 | $75.2K |
| 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… | 179 | 2,050 | 300 | $50 | $72.3K |
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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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