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NPI 1245554419 · Albuquerque, NM · Methadone Clinic
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Albuquerque Health Services is a methadone clinic provider located in Albuquerque, New Mexico. This profile covers 2 Medicare and 13 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 | Albuquerque Health Services |
| Address | 172 Montano Rd Nw |
| City | Albuquerque |
| State | NM |
| ZIP | 87107 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | March 17, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $35.4M |
| Medicare | $195.8K |
ALBUQUERQUE HEALTH SERVICES operates as a methadone clinic: its Medicare billing is dominated by G2067 (medication assisted treatment, methadone weekly bundle) and Medicaid billing is dominated by H0020 (methadone administration/service). The presence of codes such as G2067, H0020, H0025 (behavioral health prevention education), H2000 (comprehensive multidisciplinary evaluation), and T1007 (treatment plan development) indicates an integrated opioid treatment program model that combines medication dispensing with counseling, education, and multidisciplinary assessment.
Revenue is highly concentrated around a small number of services for both payers: the top 3 Medicare codes by revenue account for 100.0% of the provider's Medicare revenue, and the top 3 Medicaid codes account for 96.4% of the provider's Medicaid revenue. In particular, a single Medicare code, G2067, represents 90.3% of Medicare revenue while H0020 represents 84.9% of Medicaid revenue, so shifts in policy or reimbursement for those codes would have outsized impact on overall revenue.
The provider's payer mix is heavily skewed toward Medicaid in scale: total Medicare revenue is $195.8K versus total Medicaid revenue of $35.4M, so Medicaid payments overwhelmingly fund operations. Given that disparity, this entity should be considered effectively Medicaid-focused for financial and network-impact analyses rather than a balanced Medicare/Medicaid practice.
Nationally on Medicare G2067 is a modest, typical-volume participant: it ranks #341 of 830 providers (59th percentile) with a label of "typical, unremarkable volume for this code," and the secondary Medicare code G2078 also shows typical volume (rank #183 of 493, 63th percentile). Those percentiles and rank positions suggest the clinic is not a national leader on Medicare for these services but participates at an expected level for an opioid treatment program.
State-level competitive standing on Medicaid is mixed: the provider's largest Medicaid driver, H0020, accounts for the bulk of Medicaid revenue (84.9%) but ranks #10 of 16 in-state (40th percentile), indicating it is not among the top in-state performers on that dominant code. By contrast, the clinic shows notably above-typical state volumes for H0025 (rank #2 of 15; 93th percentile) and H2000 (rank #4 of 50; 94th percentile), which signals localized strengths in prevention education and comprehensive multidisciplinary evaluation despite not being the top H0020 operator in the state.
Beyond dispensing bundles, the billing mix shows meaningful behavioral-health and medical-management activity on Medicaid: 99214 appears with 4.8K claims and $578.6K revenue (1.6% of Medicaid revenue), T1007 has 3.8K claims and $545K revenue (1.5%), and H0001 shows 1.6K claims and $107K revenue while ranking #1 of 13 in-state (100th percentile; notably above typical state volume). These entries indicate the clinic bills for office-based evaluation/management, treatment planning, and formal assessments in addition to medication administration, consistent with an opioid treatment program offering bundled psychosocial services.
There are small but notable line items showing ancillary or operational variation: Q3014 (telehealth originating site facility fee) accounts for 875 claims and $13.1K revenue, and the Medicaid listing includes 165 claims for G2078 with $0 revenue (rank #1 of 2 in-state), which may reflect payment policy differences or non‑reimbursed take‑home supply billing practices rather than core revenue drivers. Analysts should treat these as operational details to confirm with plan-specific payment rules rather than evidence of material revenue contribution.
The provider has an established presence in the market, with its NPI enumerated on 2010-03-17 (~16 years ago), which supports continuity in referral patterns and payer relationships for a clinic whose model centers on long-term medication-assisted treatment services. That tenure, combined with the Medicaid concentration and above-typical state rankings on specific behavioral-health codes, suggests a stable, Medicaid-facing operation with niche strengths in prevention education and comprehensive evaluations.
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… | 770 | $230 | $176.9K |
| 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 | 490 | $40 | $19K |
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.
13 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) | 156,540 | $190 | $30.1M |
| H0025 | Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) | 27,260 | $110 | $2.9M |
| H2000 | Comprehensive multidisciplinary evaluation | 2,260 | $540 | $1.2M |
| 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… | 4,780 | $120 | $578.6K |
| T1007 | Alcohol and/or substance abuse services, treatment plan development and/or modification | 3,790 | $140 | $545K |
| H0001 | Alcohol and/or drug assessment | 1,620 | $70 | $107K |
| H0031 | Mental health assessment, by non-physician | 120 | $130 | $16K |
| Q3014 | Telehealth originating site facility fee | 880 | $20 | $13.1K |
| 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… | 90 | $110 | $9.3K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 170 | $20 | $2.7K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Mexico median
13 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) | 10 | 20 | 290,440 | $20 | $12.3M |
| H0025 | Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) | 2 | 20 | 7,950 | $80 | $839K |
| Q3014 | Telehealth originating site facility fee | 79 | 180 | 620 | $160 | $546.7K |
| 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… | 764 | 930 | 910 | $80 | $521.6K |
| 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… | 196 | 960 | 1,010 | $90 | $490K |
| H2000 | Comprehensive multidisciplinary evaluation | 4 | 50 | 170 | $690 | $380.3K |
| 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… | 917 | 920 | 860 | $120 | $361.9K |
| H0031 | Mental health assessment, by non-physician | 20 | 40 | 120 | $160 | $209.6K |
| T1007 | Alcohol and/or substance abuse services, treatment plan development and/or modification | 8 | 50 | 410 | $140 | $198.8K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 284 | 320 | 220 | $110 | $146.2K |
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Other providers in the same ZIP code as Albuquerque Health Services, ranked by combined Medicare and Medicaid revenue.
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