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NPI 1811954373 · Spokane, WA · Public Health or Welfare Agency
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Spokane Regional Health District is a public health or welfare agency provider located in Spokane, Washington. 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 | Spokane Regional Health District |
| Address | 1101 W College Ave |
| City | Spokane |
| State | WA |
| ZIP | 99201 |
| Taxonomy | Public Health or Welfare Agency |
| NPI Enumerated | April 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $33M |
| Medicare | $315.3K |
Payer mix and scale: Spokane Regional Health District reports $315.3K in lifetime Medicare revenue versus $33M in lifetime Medicaid revenue, indicating the provider is effectively Medicaid-dominant by scale. Medicare activity exists but is small relative to Medicaid, so analyses of financial exposure and program impact should focus primarily on Medicaid billing patterns.
Primary service line and operational focus: The billing mix is concentrated in opioid treatment services — the top Medicare and Medicaid codes are G2067 and H0020, which represent weekly methadone treatment bundles and methadone administration respectively. Presence of G2078 (take-home methadone supply) and therapy/psychotherapy codes (90837, 90834) further supports that the organization operates as a methadone-focused treatment program offering both medication dispensing and associated counseling.
Revenue concentration by payer: Medicare’s top three codes account for 100.0% of its reported Medicare revenue, with G2067 alone accounting for 93.1% of Medicare receipts. On the Medicaid side, the top three codes account for 99.7% of Medicaid revenue, and H0020 alone represents 94.6% of the provider’s Medicaid revenue, signaling extreme concentration in a single service line at both payers.
Medicare competitive standing: Medicare activity for the primary code G2067 ranks #146 of 830 providers nationally (83th percentile) and is characterized in the dataset as "typical, unremarkable volume for this code," indicating the provider participates at a fairly common national level for Medicare-covered OTP services but is not a national leader. The Medicare secondary codes (G2078 and G2074) are also labeled as "typical, unremarkable volume for this code," reinforcing a modest national footprint.
Medicaid competitive standing in-state: For Medicaid H0020 the provider ranks #19 of 60 in-state (69th percentile) and is described as "typical, unremarkable volume for this code," so it sits in the mid-to-upper tier locally for methadone administration. By contrast, T2022 (case management) ranks #3 of 15 in-state (86th percentile) and G2067 ranks #2 of 18 in-state (94th percentile), both noted as "typical, unremarkable volume for this code," which together suggest the provider occupies a relatively strong position within Washington for bundled OTP services and monthly case management.
Operational throughput signals in Medicaid claims: The provider reported 276.2K claims for H0020 ($31.2M revenue) and 10.3K claims for T2022 ($1.6M revenue), showing a very high volume of per-dispensing encounters and steady monthly case-management billing under Medicaid. Smaller but present psychotherapy billing (90837: 771 claims, $79.4K) indicates co-delivery of counseling services, but these generate only a sliver of total Medicaid revenue compared with H0020.
Tenure and organizational profile: The NPI was enumerated on 2006-04-27 (~20 years ago) and the taxonomy is Public Health or Welfare Agency, which aligns with a longstanding public-sector agency operating sustained opioid treatment services rather than a recent entrant or a private clinic. That tenure supports interpretation of the billing pattern as established programmatic activity.
Data quality and atypical reporting flags: Several commonly billed behavioral-health codes appear with nonzero claim counts but $0 reported revenue in the Medicaid list (examples include 96153, T1016, H0047, H0001, H0004), which should prompt reviewers to validate whether those lines represent zero-paid encounters, bundled payments reported under other primary codes (H0020/G2067), or data artifacts. Most high-volume codes in both payers are nevertheless described as "typical, unremarkable volume for this code," so the pattern is consistent with a focused OTP provider rather than isolated outlier billing behavior.
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… | 1,430 | $210 | $293.8K |
| 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 | 450 | $40 | $16.2K |
| 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… | 30 | $160 | $5.4K |
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) | 276,210 | $110 | $31.2M |
| T2022 | Case management, per month | 10,270 | $160 | $1.6M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 2,210 | $50 | $104K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 770 | $100 | $79.4K |
| 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… | 80 | $90 | $7.3K |
| H0046 | Mental health services, not otherwise specified | 370 | $10 | $4.8K |
| 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 | 640 | $10 | $4.5K |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 20 | $10 | $240 |
| 96153 | N/A | 1,890 | $0 | $0 |
| H0001 | Alcohol and/or drug assessment | 160 | $0 | $0 |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington 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) | 19 | 60 | 18,030 | $10 | $4.1M |
| T2022 | Case management, per month | 3 | 20 | 1,980 | $160 | $793.3K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 131 | 320 | 2,080 | $60 | $495.5K |
| H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | 28 | 30 | 2,790 | $10 | $267.2K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 447 | 930 | 680 | $60 | $259.2K |
| 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… | 304 | 390 | 420 | $50 | $152.3K |
| 96153 | N/A | 124 | 210 | 2,910 | $20 | $105.2K |
| H0001 | Alcohol and/or drug assessment | 130 | 210 | 220 | $150 | $104K |
| H0046 | Mental health services, not otherwise specified | 129 | 210 | 800 | $10 | $30.6K |
| 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 | 220 | $40 | $29.1K |
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Other providers in the same ZIP code as Spokane Regional Health District, ranked by combined Medicare and Medicaid revenue.
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