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NPI 1487889655 · New Haven, CT · Methadone Clinic
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Apt Foundation Inc is a methadone clinic provider located in New Haven, Connecticut. This profile covers 3 Medicare and 9 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 | Apt Foundation Inc |
| Address | 1 Long Wharf Dr |
| City | New Haven |
| State | CT |
| ZIP | 06511 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | May 18, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $11.6M |
| Medicare | $1.2M |
APT FOUNDATION INC operates as a methadone clinic, and its billed services are concentrated in opioid treatment program bundles and methadone dispensing codes. The Medicare top code G2067 (medication assisted treatment, methadone weekly bundle) and Medicaid H0020 (methadone administration/service) together reflect a service mix focused on medication-assisted treatment, dispensing/administration, counseling components, and toxicology testing as part of routine program delivery.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 100.0% of this provider's Medicare revenue, with G2067 alone comprising $1.1M (90.6% of Medicare revenue) and G2078 contributing $114.2K (9.3%). Total Medicare revenue for this provider is $1.2M, indicating that these opioid treatment program codes are the exclusive drivers of Medicare inflow.
Medicaid revenue is even more dominated by a single code: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, with H0020 making up $11.4M (98.9% of Medicaid revenue), while G2067 and G2078 contribute $116.4K (1.0%) and $13.1K (0.1%) respectively. Total Medicaid revenue is $11.6M, showing that on the Medicaid side nearly all payments are for methadone administration/service.
On payer mix, this provider is effectively Medicaid-dominant: reported Medicaid revenue of $11.6M far exceeds Medicare revenue of $1.2M, indicating that the clinic’s scale and reimbursement base are concentrated in state Medicaid programs rather than Medicare. Analysts should treat APT FOUNDATION INC as a primarily Medicaid-funded opioid treatment program when assessing network exposure or contracting leverage.
Competitive standing on Medicare shows strong national presence for key OTP codes: G2067 ranks #18 of 830 providers nationally (98th percentile) and is labeled notably above typical national volume, while G2078 ranks #6 of 493 providers nationally (99th percentile) and is also labeled notably above typical national volume. At the same time, Medicare code G2076 is modest by comparison (13 claims, $2.4K, ranks #56 of 84 nationally, 22th percentile), suggesting the clinic’s Medicare activity centers on dispensing and bundled weekly treatment more than intake care billed under G2076.
Competitive standing in-state for Medicaid is more middle-of-market: H0020 ranks #11 of 25 providers in-state (58th percentile) and is described as typical, unremarkable volume, while G2067 (rank #7 of 12, 45th percentile) and G2078 (rank #3 of 6, 60th percentile) show the provider is an established local participant but not a statewide dominant payer for those CPT/HCPCS lines. This pattern aligns with the heavy Medicaid revenue concentration in H0020 without outsized statewide dominance across multiple lines.
Administrative and data-quality signals worth noting: several high-claim Medicaid codes appear with large claim counts but $0 avg paid/claim and $0 revenue (for example 90853: 7.6K claims, $0 avg paid/claim, $0 revenue; 80305: 27.1K claims, $0 avg paid/claim, $0 revenue; 90832: 21.9K claims, $0 avg paid/claim, $0 revenue). These entries indicate recorded activity in those service categories without captured paid Medicaid dollars in the dataset and may reflect bundled reimbursement, external lab/payment arrangements, or reporting artifacts that merit follow-up if reimbursement per-service analysis is required.
The provider has longstanding enrollment: the NPI was enumerated on 2009-05-18 (~17 years ago), which suggests an established operational history in the market. Combined with cumulative lifetime revenue of $1.2M Medicare and $11.6M Medicaid, the tenure and scale support characterization of APT FOUNDATION INC as a persistent, Medicaid-focused opioid treatment program in New Haven, CT.
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… | 4,450 | $250 | $1.1M |
| 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 | 3,090 | $40 | $114.2K |
| 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… | 10 | $180 | $2.4K |
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.
9 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) | 815,320 | $10 | $11.4M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 1,120 | $100 | $116.4K |
| 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 | 390 | $30 | $13.1K |
| 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… | 27,080 | $0 | $0 |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 4,600 | $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… | 21,920 | $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… | 90 | $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… | 7,550 | $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… | 580 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
9 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) | 11 | 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… | 36 | 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… | 431 | 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… | 90 | 300 | 2,660 | $20 | $181.1K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 42 | 560 | 80 | $80 | $90.3K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 7 | 10 | 1,320 | $40 | $85.8K |
| 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… | 9 | 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… | 20 | 130 | 150 | $20 | $10.5K |
| 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 | 3 | 10 | 250 | $1 | $3.5K |
Other providers in the same ZIP code as Apt Foundation Inc, ranked by combined Medicare and Medicaid revenue.
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