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NPI 1861902926 · Brattleboro, VT · Substance Use Disorder Rehabilitation Clinic/Center
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Habit Opco, LLC is a substance use disorder rehabilitation clinic/center provider located in Brattleboro, Vermont. This profile covers 5 Medicare and 3 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 | Habit Opco, LLC |
| Address | 16 Town Crier Dr |
| City | Brattleboro |
| State | VT |
| ZIP | 05301 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | October 3, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.5M |
| Medicare | $463.1K |
HABIT OPCO, LLC’s billing mix and taxonomy are consistent with an opioid treatment program focused on methadone maintenance and medication‑assisted treatment. The provider’s top Medicare codes—G2067 (weekly methadone bundle), G2078 (take‑home methadone supply), and G2074 (weekly bundle not including the drug)—and its dominant Medicaid code H0020 (methadone administration/service) all describe dispensing, counseling, group therapy and toxicology testing, indicating the operation centers on recurring addiction treatment services rather than episodic procedures.
Medicare revenue is highly concentrated in a small set of OTP services: the precomputed top 3 Medicare codes account for 98.8% of this provider’s total Medicare revenue, with G2067 alone at $372.7K (80.5% of Medicare revenue) across 1.6K claims. This concentration signals that most Medicare dollars to this entity come from the weekly medication‑assisted treatment bundle rather than ancillary services.
Medicaid revenue is effectively mono-line: the precomputed top 3 Medicaid codes account for 100.0% of Medicaid revenue, and H0020 represents $1.5M (99.7% of Medicaid revenue) across 3.2K claims. In practical terms, Medicaid receipts for this provider are almost entirely attributable to methadone administration services billed under H0020.
Payer mix strongly favors Medicaid by scale: total Medicaid revenue is $1.5M compared with total Medicare revenue of $463.1K, so Medicaid is the larger source of public payer revenue for this provider. This pattern makes the organization materially more dependent on Medicaid reimbursement and utilization of methadone dosing services than on Medicare.
National competitive standing for the provider’s Medicare OTP services is mixed but generally within expected ranges: G2067 ranks #119 of 830 nationally (86th percentile) and is described as typical, unremarkable volume; G2078 ranks #27 of 493 (95th percentile) and—while the comparator text still labels it typical, unremarkable—its percentile placement indicates relatively high activity nationally for take‑home methadone supply. Other Medicare codes such as G2074 (#33 of 179, 81th percentile) and G2077 (#225 of 352, 34th percentile) further show the provider participates at customary volumes for OTP services rather than as an extreme outlier.
State-level Medicaid standing appears modest: H0020 ranks #9 of 9 in-state (0th percentile; typical, unremarkable volume) despite representing $1.5M in revenue for this provider. The in-state rank and percentile suggest this provider is not a leading Medicaid biller for methadone relative to the small set of Vermont peers, even though H0020 dominates its own Medicaid receipts.
Tenure and operational stability are evident: the NPI was enumerated on 2017-10-03 (~9 years ago), indicating several years of enrollment during which the organization established its methadone‑focused service mix. Combined with the concentrated code mix and claim counts (e.g., 1.6K Medicare claims for G2067 and 3.2K Medicaid claims for H0020), the pattern is consistent with an established, ongoing maintenance treatment program.
The heavy dependence on bundled medication‑assisted treatment codes implies operational sensitivity to OTP payment or policy changes: because G2067 and H0020 together drive the vast majority of Medicare and Medicaid revenue (98.8% and 100.0%, respectively), reimbursement or utilization shifts for those specific service bundles would disproportionately affect the provider’s overall public-payer revenue. From a contracting or program-planning perspective, payers and analysts should treat this entity primarily as a methadone dispensing and counseling provider rather than a diversified behavioral health clinic.
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… | 1,590 | $240 | $372.7K |
| 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 | 1,330 | $40 | $50.4K |
| 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… | 190 | $180 | $34K |
| 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 | $110 | $3.6K |
| 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 | $170 | $2K |
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.
3 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) | 3,160 | $460 | $1.5M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 20 | $100 | $2.1K |
| 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 | 20 | $100 | $2.1K |
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
3 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 | 10 | 17,110 | $40 | $13.6M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 8 | 10 | 120 | $190 | $4.1M |
| 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 | 10 | 27,460 | $40 | $969.3K |
Other providers in the same ZIP code as Habit Opco, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Winston L. Prouty Center For Child Development, Inc. | VT | Developmentally Disabled Services Day Training Agency | $0 | $5.5M |
| Rescue Inc. | VT | Ambulance | $1M | $3.3M |
| Brattleboro Memorial Hospital | VT | General Acute Care Hospital | $0 | $2.4M |
| Lincare Inc. | VT | Durable Medical Equipment & Medical Supplies | $0 | $915K |
| Windham County Dental Center Inc | VT | Dental Clinic/Center | $0 | $621.8K |
| Youth Services, Inc. | VT | Mental Health Counselor | $0 | $600.4K |
| Green Mountain Counseling Associates | VT | Mental Health Counselor | $0 | $598.2K |
| Erin Berard | VT | Mental Health Counselor | $0 | $571.5K |
| Timothy Whitney | VT | Mental Health Counselor | $0 | $555.1K |
| James Carew | VT | Social Worker | $0 | $489.1K |
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