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NPI 1851390629 · Waterville, ME · Methadone Clinic
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Discovery House Of Central Maine, Inc. is a methadone clinic provider located in Waterville, Maine. This profile covers 4 Medicare and 15 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 | Discovery House Of Central Maine, Inc. |
| Address | 40 Airport Road |
| City | Waterville |
| State | ME |
| ZIP | 04901 |
| Taxonomy | Methadone Clinic |
| NPI Enumerated | July 14, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $24.5M |
| Medicare | $398.8K |
DISCOVERY HOUSE OF CENTRAL MAINE, INC. is operating as an opioid treatment program (Methadone Clinic) based on its claim mix: high-volume methadone administration and dispensing codes appear for both payers (H0020, G2067), supported by counseling/assessment and case management CPTs. The presence of weekly bundled OTP codes and take-home supply codes indicates on-site dosing plus ancillary services such as substance use counseling, group/individual therapy, toxicology testing, and periodic assessments.
The provider is effectively Medicaid-centric: total Medicaid revenue is $24.5M versus total Medicare revenue of $398.8K, so Medicaid billing dominates the revenue base. Medicare activity exists but is small in scale relative to Medicaid, making the organization heavily dependent on state Medicaid reimbursement flows.
Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes account for 99.7% of this provider's Medicare revenue, with G2067 alone generating $354.3K (88.9% of the provider's Medicare revenue). G2067 ranks #122 of 830 nationally (85th percentile) and is labeled as typical, unremarkable volume for the code, while G2078 ($39.9K, 10.0%) and G2077 ($3K, 0.8%) likewise reflect routine OTP-related billings.
Medicaid revenue is even more concentrated: the precomputed top 3 Medicaid codes account for 97.3% of Medicaid revenue, and H0020 is the primary driver with $22.8M, representing 93.6% of the provider's Medicaid revenue. H0020 ranks #1 of 14 in-state (100th percentile) and is noted as notably above typical state volume; J0574 ($549K, 2.3%) and G2067 ($360.6K, 1.5%) also rank #1 in-state (100th percentile), indicating this provider is the leading in-state filer for several core medication-treatment codes.
Competitive standing differs by payer: for Medicaid the provider is a dominant statewide player for methadone administration (H0020 rank #1/14, 100th percentile, notably above typical state volume), and also leads state volume for buprenorphine/naloxone (J0574) and the G2067 bundle. By contrast, its Medicare positioning is moderate at the national level—G2067 sits at the 85th percentile nationally (rank #122/830) and Medicare volumes are described as typical, unremarkable for the top codes.
Operationally, the billing mix indicates a dispensing-first OTP model: the vast majority of Medicaid revenue is tied to H0020 (methadone administration and/or service), with secondary revenue lines from medication-supply codes (J0574, G2067) and ancillary services (H0047, T2022, 99408) contributing minimal shares. This pattern suggests on-site dosing and medication dispensing are the center of throughput, with counseling and case management present but materially smaller revenue streams.
The extreme concentration of Medicaid revenue in a single code (H0020 at $22.8M, 93.6% of Medicaid revenue) creates exposure to payer policy, fee schedule, or contracting changes affecting that code; any material change to H0020 reimbursement or eligibility could disproportionately impact overall revenue. Given the provider’s leading in-state ranks for core OTP codes, changes in state program rules or oversight would have outsized financial and operational implications for this entity.
The provider has long tenure in the national registry, with an NPI enumerated on 2005-07-14 (~21 years ago), and sustained high Medicaid volume implies it is an established operational presence in Maine’s opioid treatment infrastructure. That longevity coupled with top in-state rankings for key medication codes supports the view that the organization is a longstanding, central OTP provider within its state network.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 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… | 1,560 | $230 | $354.3K |
| 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 | 1,050 | $40 | $39.9K |
| 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 | $100 | $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… | 10 | $120 | $1.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
15 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) | 221,690 | $100 | $22.8M |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 39,210 | $10 | $549K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 18,030 | $20 | $360.6K |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 1,370 | $190 | $262.4K |
| T2022 | Case management, per month | 540 | $370 | $197.2K |
| 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. | 470 | $160 | $73.5K |
| H2010 | Comprehensive medication services, per 15 minutes | 1,770 | $30 | $56.8K |
| 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 | 6,370 | $1 | $25.5K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 980 | $20 | $19.6K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 2,590 | $1 | $10.4K |
Showing 1–10 of 15
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
15 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 | 61,180 | $110 | $9.2M |
| H2010 | Comprehensive medication services, per 15 minutes | 31 | 50 | 3,690 | $130 | $1.6M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 140 | 290 | 860 | $80 | $805.1K |
| T2022 | Case management, per month | 25 | 40 | 800 | $190 | $780.3K |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 10 | 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. | 20 | 30 | 740 | $240 | $301.1K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 1 | 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… | 1 | 10 | 5,260 | $10 | $78.6K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 3 | 10 | 3,170 | $1 | $25.6K |
| 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 | 3 | 10 | 950 | $1 | $6.5K |
Showing 1–10 of 15
Other providers in the same ZIP code as Discovery House Of Central Maine, Inc., ranked by combined Medicare and Medicaid revenue.
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