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NPI 1467416206 · Rutland, VT · Psychiatric Hospital Unit
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Rutland Hospital, Inc. is a psychiatric hospital unit provider located in Rutland, Vermont. This profile covers 3 Medicare and 21 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 | Rutland Hospital, Inc. |
| Address | 160 Allen St |
| City | Rutland |
| State | VT |
| ZIP | 05701 |
| Taxonomy | Psychiatric Hospital Unit |
| NPI Enumerated | April 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $13.3M |
| Medicare | $396.2K |
Medicaid is the clear revenue driver for this entity: lifetime Medicaid revenue is $13.3M versus total Medicare revenue of $396.2K, so the provider is effectively Medicaid-dominant in scale and reliance. That imbalance indicates operations and contracting will be far more sensitive to Medicaid reimbursement and state policy than to Medicare changes.
The provider’s activity profile is consistent with an opioid treatment program within a psychiatric hospital unit: Medicare is concentrated in G2067 (medication assisted treatment, methadone weekly bundle) which accounts for $391.3K and 98.8% of Medicare revenue, and Medicaid is concentrated in H0020 (methadone administration/service) plus multiple buprenorphine codes J0575/J0573/J0574/J0572 and psychotherapy codes like 90837. This code mix implies on-site dispensing of methadone, regular counseling and group therapy, toxicology testing and medication-assisted treatment integrated with psychiatric services.
Revenue concentration is extreme on each payer: the top 3 Medicare codes account for 100.0% of Medicare revenue and G2067 alone is 98.8% of that total, while the top 3 Medicaid codes account for 93.3% of Medicaid revenue with H0020 comprising 86.8%. Such concentration creates exposure to reimbursement changes, regulatory shifts for OTP services, or coding/coverage policy updates that affect a very small set of codes.
Medicare competitive standing on the primary OTP code is modest nationally: G2067 ranks #112 of 830 providers nationally (87th percentile; typical, unremarkable volume for this code), indicating solid but not dominant national placement for that service line. Secondary Medicare OTP codes show low national placement (G2078 rank #475 of 493, 4th percentile; G2077 rank #343 of 352, 0th percentile) so Medicare activity is heavily centralized in a single billable bundle rather than diversified across related OTP billings.
Within Vermont Medicaid, the provider is a mid-sized participant for the core methadone service: H0020 ranks #4 of 9 in-state (63th percentile; typical, unremarkable volume for this code), and the buprenorphine supply code J0575 ranks #3 of 7 (67th percentile; typical, unremarkable volume). Those placements indicate the provider is one of a handful of local OTP or medication-dispensing sites but not the single dominant program in-state.
One Medicaid code stands out positively for broader behavioral health work: 90792 (psychiatric evaluation) ranks #3 of 29 in-state (93th percentile; notably above typical state volume for this code), suggesting the provider performs a relatively high volume of psychiatric evaluations compared with peers and likely provides assessment-driven behavioral health intake or consult services beyond medication dispensing.
Operational footprint appears blended: high-volume dispensing codes (H0020, J0575 series, G2067) combined with psychotherapy (90837, 90834) and inpatient/outpatient E/M codes (99232, 99214, 99231) indicate the organization operates both OTP dispensing and broader psychiatric treatment services including counseling and inpatient/subsequent inpatient care. This mix signals integrated clinical workflows (medication management, counseling, and inpatient evaluation) rather than a narrow pharmacy-only model.
The provider has a long tenure in the NPI registry (NPI enumerated 2006-04-17, ~20 years ago), which supports interpreting these utilization patterns as established practice behavior rather than a short-term reporting anomaly. That longevity combined with concentrated OTP billing suggests any strategic or contract negotiations should prioritize Medicaid OTP reimbursement and the clinical services that support MAT delivery.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 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… | 1,660 | $240 | $391.3K |
| 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 | 90 | $40 | $3.5K |
| 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… | 10 | $110 | $1.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 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.
21 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) | 24,850 | $470 | $11.6M |
| J0575 | Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine | 5,010 | $140 | $676.2K |
| J0573 | Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine | 3,890 | $50 | $182.7K |
| 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… | 4,840 | $40 | $174.3K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 9,270 | $20 | $148.3K |
| 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… | 4,700 | $30 | $145.6K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 3,040 | $40 | $121.4K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 4,780 | $30 | $119.4K |
| 90792 | In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical… | 840 | $50 | $43K |
| 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… | 1,630 | $30 | $42.3K |
Showing 1–10 of 21
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
21 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) | 4 | 10 | 17,110 | $40 | $13.6M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 2 | 10 | 120 | $190 | $4.1M |
| J0575 | Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine | 3 | 10 | 1,360 | $50 | $551.1K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 6 | 10 | 6,550 | $30 | $483.4K |
| 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… | 58 | 320 | 680 | $30 | $146.1K |
| 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… | 91 | 670 | 760 | $70 | $143.9K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 4 | 20 | 630 | $30 | $118.5K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 2 | 10 | 1,470 | $10 | $107.9K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 8 | 10 | 510 | $40 | $103.2K |
| J0573 | Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine | 2 | 10 | 3,890 | $20 | $101.4K |
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Other providers in the same ZIP code as Rutland Hospital, Inc., ranked by combined Medicare and Medicaid revenue.
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