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NPI 1548707748 · Marion, IN · Methadone Clinic
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Premier Care Of Indiana, Inc. is a methadone clinic provider located in Marion, Indiana. This profile covers 3 Medicare and 5 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 | Premier Care Of Indiana, Inc. |
| Address | 317 S Norton St |
| City | Marion |
| State | IN |
| ZIP | 46952 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | January 25, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $33.8M |
| Medicare | $309.7K |
This provider is effectively Medicaid-dominant: reported lifetime Medicaid revenue is $33.8M versus total Medicare revenue of $309.7K, indicating that the vast majority of its billing and cash flow is tied to Medicaid rather than Medicare. The scale gap suggests payer-mix risk concentrated on state program reimbursement and policy changes.
Revenue is highly concentrated in a very small set of services for both payers: the top 3 Medicare codes by revenue account for 100.0% of Medicare revenue, and the top 3 Medicaid codes account for 99.6% of Medicaid revenue. That concentration signals the organization operates with a narrow service mix focused on opioid treatment program (OTP) activities rather than a broad outpatient portfolio.
The clinic-level service model is clear from its code mix: Medicaid H0020 (1.4M claims, $16 avg paid/claim, $22.3M revenue) and Medicaid G2067 (61.4K claims, $189 avg paid/claim, $11.6M revenue) dominate Medicaid billing, while Medicare G2067 (1.2K claims, $227 avg paid/claim, $281.5K revenue) is the primary Medicare activity. These codes correspond to methadone administration and an all‑inclusive weekly medication-assisted treatment bundle, consistent with a high-volume methadone dispensing and counseling operation.
Within the state Medicaid market the provider is a leading participant: H0020 ranks #2 of 28 providers in-state (96th percentile) and G2067 ranks #2 of 24 providers in-state (96th percentile), while G2077 ranks #1 of 13 providers in-state (100th percentile, labeled an "extreme outlier, far above typical state volume"). Taken together, these ranks indicate the clinic is a major statewide provider for methadone administration and related OTP assessments.
By contrast its Medicare footprint is modest and nationally typical: Medicare G2067 is $281.5K (90.9% of this provider's total Medicare revenue) and ranks #184 of 830 providers nationally (78th percentile, characterized as typical/unremarkable volume), and the other Medicare codes (G2172 and G2077) also sit in typical percentile ranges. This pattern indicates Medicare is not the primary competitive arena for this provider at a national level.
Operational intensity is evidenced by very large Medicaid claim volumes: 1.4M claims for H0020 and 61.4K claims for Medicaid G2067, alongside smaller but meaningful counts for ancillary OTP codes such as G2077 (5.6K claims) and G2078 (4.7K claims). Those volumes are consistent with daily or weekly dispensing and recurring counseling visits inherent to methadone treatment programs, implying operational scale and recurring throughput.
The provider shows a narrow clinical footprint focused on OTP-specific services (intake, periodic assessment, dosing/dispensing, and take-home supply) as demonstrated by Medicaid G2077 (5.6K claims, $346.8K revenue) and G2078 (4.7K claims, $108.8K revenue) appearing among the top-billed codes. This code mix suggests revenue depends on both medication dispensing and bundled service packages that include counseling and toxicology testing.
Tenure is established but relatively recent: the NPI was enumerated on 2017-01-25 (~9 years ago), meaning the organization built its current Medicaid-dominant footprint within approximately a decade. Given the high Medicaid concentration and code-specific reliance, any regulatory or reimbursement changes to methadone/MAT coding or rates would likely have an outsized impact on this provider’s financials.
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… | 1,240 | $230 | $281.5K |
| G2172 | All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project | 50 | $330 | $15.6K |
| 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… | 120 | $110 | $12.5K |
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.
5 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) | 1,392,800 | $20 | $22.3M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 61,400 | $190 | $11.6M |
| 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… | 5,590 | $60 | $346.8K |
| 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 | 4,730 | $20 | $108.8K |
| 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… | 120 | $130 | $15.7K |
How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Indiana median
5 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) | 2 | 30 | 240,980 | $20 | $6.4M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 2 | 20 | 24,350 | $170 | $4.1M |
| 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 | 4 | 20 | 1,490 | $30 | $75K |
| 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… | 1 | 10 | 780 | $60 | $64.5K |
| 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… | 9 | 10 | 120 | $90 | $22.8K |
Other providers in the same ZIP code as Premier Care Of Indiana, Inc., ranked by combined Medicare and Medicaid revenue.
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