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NPI 1629685045 · Washington, DC · Substance Use Disorder Rehabilitation Clinic/Center
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Baymark Health Services Of West Virginia, Inc. is a substance use disorder rehabilitation clinic/center provider located in Washington, District of Columbia. This profile covers 3 Medicare and 13 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 | Baymark Health Services Of West Virginia, Inc. |
| Address | 2112 F St Nw Ste 102 |
| City | Washington |
| State | DC |
| ZIP | 20037 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | September 29, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.4M |
| Medicare | $571.6K |
This provider’s taxonomy and code mix are consistent with an opioid treatment program focused on methadone-based medication-assisted treatment: the Medicare top code G2067 (medication assisted treatment, methadone; weekly bundle) and the Medicaid top code H0020 (methadone administration/service) dominate billing across payers and reflect bundled dispensing, counseling, and toxicology testing typical of a substance use disorder rehabilitation clinic. The presence of frequent counseling (H0004) and large-volume drug-screening (80307) codes on the Medicaid side supports an integrated MAT plus behavioral-health service model.
Medicare revenue is highly concentrated: the top 3 Medicare codes account for 100.0% of the provider’s Medicare revenue, with a single code G2067 representing $548.2K and 95.9% of the provider’s total Medicare revenue. That concentration indicates the provider’s Medicare business is almost entirely driven by weekly methadone treatment bundles rather than a diversified set of Medicare services.
Medicaid revenue is similarly concentrated but slightly more distributed across ancillary services: the top 3 Medicaid codes account for 95.0% of Medicaid revenue, with H0020 alone contributing $5.3M and 84.3% of the provider’s $6.4M total Medicaid revenue. The next-largest Medicaid contributions are H0004 ($354K, 5.7%) and 80307 ($307.6K, 4.9%), showing that counseling and instrumented drug screening are the principal secondary revenue streams supporting the MAT program.
Payer mix is heavily skewed toward Medicaid: lifetime Medicaid revenue ($6.4M) is an order of magnitude larger than lifetime Medicare revenue ($571.6K), so the provider should be treated operationally as effectively Medicaid-focused for scale and population served. Strategic or payment changes on the Medicaid side—especially to H0020 reimbursement—would materially affect the provider’s overall revenue profile.
Competitive standing differs by payer and code. For the Medicaid H0020 service the provider ranks #1 of 5 in-state (100th percentile) and therefore is a dominant in-state supplier of methadone administration, though the dataset labels this as a "typical, unremarkable volume" case; on Medicare, the G2067 position (rank #74 of 830, 91th percentile) indicates a meaningful national presence for the weekly methadone bundle but at a volume described as "typical, unremarkable" relative to peers. Other Medicare codes such as G2078 (rank #158 of 493, 68th percentile) show routine, unremarkable participation, while G2077 (rank #310 of 352, 10th percentile) registers lower relative activity even as it is still described as typical for that code.
Several Medicaid-listed codes appear with non‑zero claim counts but show $0 average paid/claim and $0 revenue (for example G2078, G2067, and H0016 in the Medicaid table). This pattern suggests differences in how claims are recorded versus reimbursed in the Medicaid file (reporting or mapping of payment amounts) rather than additional earned revenue, and it is noteworthy for reconciliation and payer‑mapping work.
The operational case mix includes high-volume counseling and testing: H0004 shows 14.2K claims ($354K) and 80307 shows 11.8K claims ($307.6K), supporting a workflow that combines frequent behavioral-health encounters with instrumented drug testing. Those volumes align with the provider’s role as an ambulatory MAT clinic that pairs medication dispensing with regular clinical monitoring and counseling.
The provider’s NPI has been enumerated since 2020-09-29 (~6 years ago), indicating a multi-year presence in Medicare/Medicaid billing. Combined with the concentrated revenue in core OTP codes and the in-state leadership on H0020, the data portray an established, programmatic MAT operator rather than a short-term or incidental participant in these benefit streams.
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… | 2,050 | $270 | $548.2K |
| 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 | 540 | $40 | $21.2K |
| 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… | 20 | $130 | $2.2K |
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.
13 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) | 583,750 | $10 | $5.3M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 14,160 | $30 | $354K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 11,830 | $30 | $307.6K |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | 1,020 | $150 | $153K |
| H0001 | Alcohol and/or drug assessment | 860 | $140 | $115.7K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 930 | $20 | $17.6K |
| H2014 | Skills training and development, per 15 minutes | 650 | $20 | $13.7K |
| T1017 | Targeted case management, each 15 minutes | 550 | $20 | $11K |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 850 | $1 | $1.7K |
| H2027 | Psychoeducational service, per 15 minutes | 20 | $30 | $530 |
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How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. District of Columbia median
13 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) | 1 | 10 | 351,390 | $10 | $3.7M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 14 | 80 | 2,570 | $60 | $403K |
| H2014 | Skills training and development, per 15 minutes | 17 | 30 | 1,560 | $40 | $198.5K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 4 | 20 | 2,880 | $30 | $179.6K |
| H2027 | Psychoeducational service, per 15 minutes | 24 | 30 | 1,320 | $20 | $133.9K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 14 | 20 | 1,540 | $30 | $125.6K |
| H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | 9 | 10 | 740 | $70 | $107K |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | 17 | 50 | 520 | $70 | $98K |
| T1017 | Targeted case management, each 15 minutes | 11 | 20 | 390 | $70 | $89.9K |
| H0001 | Alcohol and/or drug assessment | 5 | 20 | 220 | $120 | $65.8K |
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Other providers in the same ZIP code as Baymark Health Services Of West Virginia, Inc., ranked by combined Medicare and Medicaid revenue.
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