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NPI 1568477297 · Bangor, ME · Mental Health Clinic/Center (Including Community Mental Health Center)
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Acadia Healthcare, Inc is a mental health clinic/center (including community mental health center) provider located in Bangor, Maine. This profile covers 1 Medicare and 12 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 | Acadia Healthcare, Inc |
| Address | 268 Stillwater Avenue |
| City | Bangor |
| State | ME |
| ZIP | 04401 |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| NPI Enumerated | July 30, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $12.9M |
| Medicare | $280.2K |
ACADIA HEALTHCARE, INC appears to operate primarily as an opioid treatment program and outpatient substance use treatment clinic: its Medicare revenue is concentrated entirely in G2067 (Medication assisted treatment, methadone) which generated $279.8K and accounts for 100.0% of the provider's Medicare revenue, and its Medicaid revenue is overwhelmingly driven by H0020 (methadone administration/service) which generated $11.2M and represents 87.3% of Medicaid revenue. The code mix (G2067, H0020, and several buprenorphine codes such as J0574/J0572/J0573) is consistent with a service model built around methadone maintenance and medication‑assisted treatment with ancillary counseling and toxicology elements. This pattern indicates the organization’s core business lines are dispensing/administration of opioid treatment medications plus associated counseling and case management.
Revenue concentration is extremely high on both payers: the precomputed top-3 Medicare codes account for 100.0% of Medicare revenue and the precomputed top-3 Medicaid codes account for 97.0% of Medicaid revenue. For Medicare that concentration is effectively a single code exposure (G2067, $279.8K of Medicare receipts), while for Medicaid the top three codes (H0020 $11.2M, H0004 $1M, J0574 $193.2K) together dominate the $12.9M lifetime Medicaid revenue. This level of concentration signals that reimbursement policy or utilization changes for a small set of codes would materially affect the provider’s overall revenue.
The provider’s payer mix is heavily Medicaid‑weighted: lifetime Medicaid revenue is $12.9M compared with $280.2K in Medicare, meaning the practice is functionally Medicaid‑dominated rather than balanced between the two programs. From an analytics or contracting perspective this makes the organization more sensitive to state Medicaid payment rates and programmatic changes than to national Medicare policy shifts. Analysts evaluating network value or financial vulnerability should treat Medicaid reimbursement for methadone services as the primary driver of financial performance.
Competitive standing by code shows a mixed picture across payers. On Medicare G2067 the provider ranks #156 of 830 nationally (81th percentile), a middle‑of‑the‑pack national presence described in the data as "typical, unremarkable volume for this code," indicating it is not an extreme national outlier. Within Maine for major Medicaid codes the provider ranks #5 of 14 on H0020 (69th percentile), which places it among the larger in‑state methadone administrators, while H0004 (behavioral health counseling) ranks #32 of 290 (89th percentile) statewide, showing relatively strong standing for counseling services in the state market.
The NPI tenure is long: the provider was enumerated on 2006-07-30 (~20 years ago), suggesting an established operation with a long billing history. That longevity supports the interpretation that the observed revenue concentration and service mix are persistent elements of the business rather than short‑term anomalies.
Several large codes are explicitly labeled in the source as "typical, unremarkable volume for this code," including Medicare G2067 and Medicaid H0020; this indicates that while dollar volumes are concentrated, the provider’s utilization levels fall within the common range for peers rather than representing extreme statistical outliers. Put differently, high revenue shares do not necessarily imply unusually high intensity per patient relative to peers; they can reflect a service focus that is common among similar providers.
There is a notable cross‑payer payment disparity for the same procedure code: G2067 averages $202 paid/claim on Medicare (1.4K claims, $279.8K revenue) but appears in Medicaid with an average of $3 paid/claim (12K claims, $35.9K revenue), highlighting material differences in unit reimbursement between the programs for ostensibly similar bundled services. This gap suggests that revenue per service—and therefore margin and operational economics—will vary substantially depending on payor mix even when identical codes are billed.
Beyond methadone dispensing, the provider bills for a range of ancillary behavioral health services that together represent modest but meaningful revenue: H0004 generated $1M (8.2% of Medicaid revenue), T2022 produced $127.1K (1.0%), and 99408 produced $100.5K (0.8%). These codes indicate the presence of counseling, case management, and screening services that supplement medication‑based treatment and may support bundled care models or integrated behavioral health programs, though each is a much smaller revenue contributor than methadone administration.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 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… | 1,390 | $200 | $279.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G2067 | 5 | 10 | 1,110 | $230 | $263K |
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.
12 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) | 94,110 | $120 | $11.2M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 17,490 | $60 | $1M |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 16,100 | $10 | $193.2K |
| T2022 | Case management, per month | 350 | $360 | $127.1K |
| 99408 | The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session. | 500 | $200 | $100.5K |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 500 | $180 | $87.8K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 11,950 | $1 | $35.9K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 3,170 | $10 | $15.9K |
| J0573 | Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine | 1,180 | $10 | $12.9K |
| H2000 | Comprehensive multidisciplinary evaluation | 80 | $60 | $4.7K |
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How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maine median
12 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 | 10 | 61,180 | $110 | $9.2M |
| H2010 | Comprehensive medication services, per 15 minutes | 49 | 50 | 3,690 | $130 | $1.6M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 32 | 290 | 860 | $80 | $805.1K |
| T2022 | Case management, per month | 26 | 40 | 800 | $190 | $780.3K |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 20 | 30 | 750 | $240 | $312.9K |
| 99408 | The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session. | 19 | 30 | 740 | $240 | $301.1K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 3 | 10 | 20,880 | $10 | $236.2K |
| 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 | 10 | 5,260 | $10 | $78.6K |
| H2000 | Comprehensive multidisciplinary evaluation | 45 | 90 | 70 | $100 | $35.4K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 2 | 10 | 3,170 | $1 | $25.6K |
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Other providers in the same ZIP code as Acadia Healthcare, Inc, ranked by combined Medicare and Medicaid revenue.
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