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NPI 1629282470 · Green Bay, WI · Methadone Clinic
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Quality Addiction Management Inc is a methadone clinic provider located in Green Bay, Wisconsin. This profile covers 5 Medicare and 11 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 | Quality Addiction Management Inc |
| Address | 2357 W Mason St |
| City | Green Bay |
| State | WI |
| ZIP | 54303 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | May 10, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $66.8M |
| Medicare | $1.2M |
This provider is effectively Medicaid-centric: reported lifetime Medicare revenue is $1.2M while lifetime Medicaid revenue is $66.8M, indicating the vast majority of billed dollars come from Medicaid rather than Medicare. The scale difference suggests the organization operates primarily within state-funded opioid treatment and related services rather than relying on Medicare volume.
Revenue is highly concentrated into a very small set of procedures for both payers: the top 3 Medicare codes account for 98.9% of this provider's total Medicare revenue, and the top 3 Medicaid codes account for 99.3% of this provider's total Medicaid revenue. That concentration indicates the business is narrowly focused on a few core OTP-related service bundles and associated testing/intervention codes rather than a broad mix of outpatient services.
Medicare activity is overwhelmingly driven by G2067, which represents $1.2M and 95.4% of the provider's Medicare revenue across 5.1K claims ($229 avg paid/claim); G2067 ranks #16 of 830 providers nationally (98th percentile) and is described as notably above typical national volume. This pattern shows the provider bills the weekly methadone bundle as its primary Medicare service, consistent with operation as a Medicare-enrolled opioid treatment program providing dispensing, counseling, and toxicology testing.
Medicaid revenue is dominated by a trio of OTP and testing codes: H0020 ($36.6M; 53.9% of Medicaid revenue; 3.3M claims), H0003 ($23.7M; 34.9% of Medicaid revenue; 370K claims), and H0022 ($7.1M; 10.5% of Medicaid revenue; 274.6K claims). Each of these three Medicaid codes ranks #1 in-state and is labeled an extreme outlier, far above typical state volume, which indicates the provider is a major in-state hub for methadone administration, laboratory drug screening, and planned intervention services.
Beyond the primary bundles, Medicare-level ancillary OTP codes show mixed participation: G2077 is a meaningful secondary Medicare code (300 claims, $32.1K revenue; ranks #10 of 352 nationally, 97th percentile, typical for that code), while codes such as G2074 and G2078 appear at modest or typical volumes. This indicates the Medicare side is concentrated on the bundled weekly service with periodic assessment activity, but fewer separate line items for take-home supplies or bundled services excluding drug costs.
The provider's in-state dominance across multiple Medicaid codes — several listed as #1 of their peer sets and repeatedly described as extreme outliers — implies substantial local market share and operational capacity for high-frequency dispensing and testing. For payers and network planners, that profile signals a single high-volume OTP with potential leverage for state-wide contracting or utilization management discussions.
Support services and lab activity are significant elements of the Medicaid business mix: H0003 (laboratory analysis) alone generates $23.7M on 370K claims (34.9% of Medicaid revenue), and related lab codes such as 99001 and 86580 also rank at or near #1 in-state. The prominence of lab-related revenue confirms that toxicology screening and specimen processing are core operational components rather than peripheral services.
The provider shows long-tenure enrollment and an established footprint: NPI enumerated on 2007-05-10 (~19 years ago). Combined with the concentrated, high-volume Medicaid billing, this longevity supports an interpretation of an established, state-focused opioid treatment provider rather than a recent entrant or sporadic operator.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 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… | 5,150 | $230 | $1.2M |
| 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… | 300 | $110 | $32.1K |
| G2074 | Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services… | 60 | $180 | $10.9K |
| 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 | 280 | $40 | $10.3K |
| 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… | 20 | $170 | $3.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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.
11 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) | 3,331,690 | $10 | $36.6M |
| H0003 | Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs | 370,030 | $60 | $23.7M |
| H0022 | Alcohol and/or drug intervention service (planned facilitation) | 274,580 | $30 | $7.1M |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 34,090 | $10 | $306.8K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 3,320 | $20 | $76.5K |
| 99001 | The provider prepares a specimen collected from a patient at a location other than the provider’s office and sends it to an outside laboratory for analysis. | 17,820 | $1 | $53.5K |
| 86580 | The lab analyst performs an intradermal skin test on a patient to test for tuberculosis. | 3,830 | $10 | $26.8K |
| 98966 | 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… | 2,740 | $10 | $16.5K |
| H0001 | Alcohol and/or drug assessment | 80 | $20 | $1.4K |
| 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… | 30 | $30 | $840 |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0003 | Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs | 1 | 100 | 150 | $60 | $657.7K |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 1 | 240 | 380 | $10 | $397.8K |
| H0022 | Alcohol and/or drug intervention service (planned facilitation) | 1 | 190 | 400 | $30 | $140.3K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 1 | 90 | 670 | $20 | $42.5K |
| H0001 | Alcohol and/or drug assessment | 5 | 20 | 40 | $210 | $31.4K |
| 99001 | The provider prepares a specimen collected from a patient at a location other than the provider’s office and sends it to an outside laboratory for analysis. | 1 | 50 | 740 | $10 | $20.7K |
| 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 | 20 | 130 | $30 | $15.8K |
| 98966 | 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… | 2 | 20 | 670 | $10 | $6.2K |
| 86580 | The lab analyst performs an intradermal skin test on a patient to test for tuberculosis. | 1 | 50 | 200 | $10 | $2.8K |
| 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 | 30 | $20 | $710 |
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Other providers in the same ZIP code as Quality Addiction Management Inc, ranked by combined Medicare and Medicaid revenue.
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