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NPI 1669017653 · Springfield, MA · Methadone Clinic
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Behavioral Health Network, Inc is a methadone clinic provider located in Springfield, Massachusetts. This profile covers 3 Medicare and 37 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 | Behavioral Health Network, Inc |
| Address | 395 Liberty St |
| City | Springfield |
| State | MA |
| ZIP | 01104 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | November 13, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $108.4M |
| Medicare | $1.3M |
This provider is overwhelmingly Medicaid-focused by scale: total Medicare revenue is $1.3M while total Medicaid revenue is $108.4M, indicating Medicaid drives the vast majority of billed activity and dollars for BEHAVIORAL HEALTH NETWORK, INC. Medicare activity is small in aggregate relative to Medicaid and concentrated in opioid treatment program billing.
Medicare billing is highly concentrated in OTP-specific codes — the top 3 Medicare codes account for 100.0% of the provider's Medicare revenue, with G2067 alone representing 92.0% of Medicare revenue. G2067 is a national high-volume outlier for this provider (ranks #12 of 830 providers nationally, 99th percentile; notably above typical national volume for this code), and G2078 also shows elevated national volume (ranks #10 of 493, 98th percentile).
The provider’s Medicaid revenue is less concentrated but still meaningfully driven by a few lines of service: the top 3 Medicaid codes account for 48.1% of Medicaid revenue, led by T1040 (25.9% of Medicaid revenue), H0019 (14.0%), and H2019 (8.2%). T1040 (Medicaid certified community behavioral health clinic services, per diem) is a standout in-state revenue driver (119.6K claims, $28M revenue; ranks #3 of 167 providers in-state, 99th percentile; extreme outlier, far above typical state volume for this code).
The mix of high-volume codes and their descriptions points to an operation built around medication‑assisted treatment and comprehensive behavioral health services: key Medicare codes are OTP bundles and take‑home supplies (G2067, G2078), and Medicaid top codes include CCBHC per-diem (T1040), long-term residential per-diem (H0019), and intensive therapy/skills services (H2019, 90834, 90832). This pattern is consistent with a methadone clinic that also operates broad behavioral health and community clinic programs for Medicaid populations.
BEHAVIORAL HEALTH NETWORK, INC is a major in-state competitor on several Medicaid lines. In addition to T1040 dominance, psychotherapy volumes are extreme outliers in Massachusetts—90834 (141.9K claims, $7.9M revenue) ranks #18 of 1617 providers in-state (99th percentile; extreme outlier, far above typical state volume) and 90832 (48.6K claims, $1.4M revenue) ranks #4 of 565 providers in-state (99th percentile; extreme outlier). These ranks indicate the provider is a leading regional supplier of outpatient psychotherapy and CCBHC services.
Operational scale is reflected in very large claim counts on multiple Medicaid codes: T1040 119.6K claims ($234 avg), H0019 81.5K claims ($185 avg), H0020 383.7K claims ($13 avg) and H0023 127.4K claims ($55 avg) show a high-volume, per-diem and per-encounter service model. The combination of high claim volumes with relatively low per-claim payments on certain codes (for example H0020 average $13 paid/claim) suggests the organization delivers many brief, frequently billed interventions alongside higher‑paid per-diem services.
On Medicare the provider appears specialized and positionally strong among Medicare-enrolled OTPs but small in absolute dollars: Medicare totals $1.3M and are entirely driven by OTP codes, while Medicaid at $108.4M is the dominant revenue source. This dual picture — Medicare prominence within a narrow OTP code set and broad, high-volume Medicaid operations — implies the provider’s strategic exposure is primarily to state Medicaid policy and reimbursement rates rather than to Medicare market shifts.
The provider’s NPI tenure is relatively recent: NPI enumerated on 2019-11-13 (~7 years ago), indicating roughly seven years of enrollment history during which it has grown to a large Medicaid footprint and a concentrated Medicare OTP profile. Given the combination of long-running, high-volume Medicaid services and niche Medicare OTP billing, analysts should view this entity as a mature Medicaid-dominant methadone/behavioral health operator with specialized Medicare OTP activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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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… | 5,850 | $210 | $1.2M |
| 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 | 2,370 | $40 | $82.9K |
| 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… | 110 | $190 | $21K |
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.
37 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 119,600 | $230 | $28M |
| H0019 | Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem | 81,550 | $190 | $15.1M |
| H2019 | Therapeutic behavioral services, per 15 minutes | 58,380 | $150 | $8.9M |
| 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… | 141,920 | $60 | $7.9M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 61,030 | $130 | $7.7M |
| H0023 | Alcohol and/or drug outreach | 127,370 | $60 | $7M |
| H2014 | Skills training and development, per 15 minutes | 38,480 | $150 | $5.9M |
| S9485 | Crisis intervention mental health services, per diem | 8,090 | $680 | $5.5M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 383,720 | $10 | $5M |
| T1027 | Family training and counseling for child development, per 15 minutes | 38,060 | $110 | $4.2M |
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How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
37 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) | 9 | 40 | 26,400 | $10 | $9.7M |
| H0019 | Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem | 9 | 80 | 5,200 | $370 | $8.4M |
| H0023 | Alcohol and/or drug outreach | 19 | 40 | 127,370 | $50 | $8.2M |
| 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 | 30 | 8,280 | $140 | $8M |
| H2036 | Alcohol and/or other drug treatment program, per diem | 4 | 10 | 3,640 | $1,120 | $7.9M |
| H2015 | Comprehensive community support services, per 15 minutes | 111 | 150 | 7,770 | $140 | $4.8M |
| S9485 | Crisis intervention mental health services, per diem | 19 | 110 | 1,250 | $540 | $3.2M |
| H2014 | Skills training and development, per 15 minutes | 47 | 190 | 21,080 | $110 | $3M |
| H2019 | Therapeutic behavioral services, per 15 minutes | 27 | 290 | 3,680 | $150 | $2.9M |
| H0040 | Assertive community treatment program, per diem | 20 | 20 | 22,090 | $50 | $2.8M |
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Other providers in the same ZIP code as Behavioral Health Network, Inc, ranked by combined Medicare and Medicaid revenue.
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