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NPI 1891234514 · Saint Albans, VT · Substance Use Disorder Rehabilitation Clinic/Center
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Baart Behavioral Health Services, Inc. is a substance use disorder rehabilitation clinic/center provider located in Saint Albans, Vermont. This profile covers 3 Medicare and 7 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 | Baart Behavioral Health Services, Inc. |
| Address | 242 S Main St |
| City | Saint Albans |
| State | VT |
| ZIP | 05478 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | February 14, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.5M |
| Medicare | $180.2K |
This provider is effectively Medicaid-dominant in scale: reported lifetime Medicaid revenue is $2.5M compared with $180.2K in Medicare, indicating the bulk of billed services and payments flow through Medicaid rather than Medicare. The precomputed concentration metrics reinforce that focus — the top 3 Medicaid codes account for 99.9% of the provider's Medicaid revenue while the top 3 Medicare codes account for 100.0% of Medicare revenue.
Medicare revenue is heavily concentrated in opioid treatment program bundles: G2067 alone accounts for $147.4K (81.8% of this provider's total Medicare revenue) with 658 claims, and the top three Medicare codes together represent 100.0% of Medicare revenue. The G2067 national rank is #398 of 830 providers (52th percentile; typical, unremarkable volume for this code), so the provider treats a routine, not leading, Medicare MAT caseload relative to national peers.
Medicaid revenue is overwhelmingly driven by methadone administration: H0020 represents $2.4M (95.7% of this provider's total Medicaid revenue) across ~5.3K claims, making it the single dominant Medicaid revenue driver. Despite that concentration, H0020 ranks #7 of 9 providers in-state (25th percentile; typical, unremarkable volume for this code), which suggests the provider captures material dollars from Medicaid but is not a top-ranked in-state H0020 billing leader.
The clinical/service-line mix is consistent with an opioid treatment program focused on methadone-based medication assisted treatment and associated counseling and toxicology services — both G2067 (Medicare weekly methadone bundle) and H0020 (Medicaid methadone administration) dominate each payer’s revenue. The presence of G2074 and G2078 on the Medicare side and 99213/99214 E/M codes on Medicaid indicates bundled MAT services are supplemented by routine outpatient evaluation and management visits.
There is a notable pattern in pharmacy J-codes on Medicaid: J0574 (6.5K claims), J0575 (655 claims), and J0572 (619 claims) are recorded with $0 avg paid/claim and $0 revenue. This mismatch between high claim counts and zero reported revenue for buprenorphine/naloxone lines suggests those drug supplies may be paid via a separate mechanism, included in bundled dispensing codes (H0020), or otherwise not reflected as paid Medicaid line-item revenue in these files — a billing pattern worth confirming with state pharmacy/payment policy.
From a competitive-ranking perspective the provider is a modest national participant in Medicare MAT codes — G2067 ranks #398 of 830 (52th percentile; typical, unremarkable volume), G2074 ranks #70 of 179 (61th percentile; typical, unremarkable volume), and G2078 ranks #287 of 493 (41th percentile; typical, unremarkable volume). On Medicaid the provider’s H0020 position (#7 of 9, 25th percentile) signals it is not a dominant in-state supplier of methadone administration despite capturing most of its Medicaid revenue through that code, while 99213 activity (#119 of 319, 63th percentile) is in the typical range for outpatient E/M services.
The provider’s billing footprint and NPI tenure are consistent with an established opioid treatment program: the taxonomy is Substance Use Disorder Rehabilitation Clinic/Center and the NPI was enumerated on 2017-02-14 (~9 years ago). Combined with the code mix dominated by methadone administration and MAT bundles, this suggests sustained operation as a methadone-focused treatment clinic over several years.
Overall revenue concentration is high on both payers and operational risk/reliance is correspondingly focused: the top 3 Medicare codes make up 100.0% of Medicare revenue and the top 3 Medicaid codes make up 99.9% of Medicaid revenue, meaning changes in reimbursement or utilization for a small set of MAT-related codes would materially impact the provider’s reported revenue streams. Given that concentration, payer or policy shifts affecting H0020 or G2067-based bundles should be treated as high-impact factors for this provider.
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… | 660 | $220 | $147.4K |
| 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… | 110 | $190 | $19.9K |
| 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 | 330 | $40 | $12.9K |
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.
7 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) | 5,350 | $450 | $2.4M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 1,460 | $50 | $75.9K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 250 | $110 | $27.7K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 130 | $20 | $2.6K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 620 | $0 | $0 |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 6,550 | $0 | $0 |
| J0575 | Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine | 660 | $0 | $0 |
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
7 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) | 7 | 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… | 3 | 10 | 120 | $190 | $4.1M |
| J0575 | Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine | 6 | 10 | 1,360 | $50 | $551.1K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 4 | 10 | 6,550 | $30 | $483.4K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 216 | 320 | 680 | $30 | $146.1K |
| J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | 6 | 10 | 1,470 | $10 | $107.9K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 119 | 320 | 760 | $20 | $88.2K |
Other providers in the same ZIP code as Baart Behavioral Health Services, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Northwestern Counseling & Support Services | VT | Community/Behavioral Health Agency | $0 | $129.9M |
| Northwestern Counseling & Support Services Inc | VT | Community/Behavioral Health Agency | $0 | $70.4M |
| Amcare Medical Systems, Inc. | VT | Land Ambulance | $576.2K | $2.2M |
| Northwestern Medical Center, Inc. | VT | Pediatrics Physician | $0 | $1.4M |
| Northwestern Medical Center, Inc. | VT | General Acute Care Hospital | $0 | $1.1M |
| Remy Vallee Dmd Inc | VT | Dentist | $0 | $1.1M |
| Calm Reflections Psychotherapy, LLC | VT | Clinical Social Worker | $0 | $840.8K |
| Northwestern Medical Center, Inc. | VT | Urgent Care Clinic/Center | $0 | $757.2K |
| Northern Valley Eyecare, Inc. | VT | Optometrist | $0 | $703.1K |
| Michelle Pelkey | VT | Clinical Social Worker | $0 | $550.9K |
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