Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Vermont for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Vermont only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Vermont (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Habit Opco, LLC (NPI 1912155516)

Field	Value
Entity Type	Organization
Organization	Habit Opco, LLC
Address	16 Town Crier Drive
City	Brattleboro
State	VT
ZIP	05304
Taxonomy	Methadone Clinic
NPI Enumerated	September 8, 2008

Payer Source	Total Paid
Medicaid	$94M
Medicare	$0

Key Findings

This entity is effectively a single-payer Medicaid provider: there is no Medicare billing on file and the provider reports $94M in total Medicaid revenue. The absence of Medicare activity indicates the organization’s revenue and payer negotiations are concentrated almost entirely within Medicaid programs.

Revenue is highly concentrated in a very small set of methadone-related services: the precomputed top 3 codes account for 97.0% of total Medicaid revenue, driven by H0020 ($56.7M, 60.3%), G2067 ($32.6M, 34.7%), and G2078 ($1.9M, 2.0%). These three codes form the financial backbone of the operation, leaving other codes as minor contributors to overall revenue.

The code mix identifies HABIT OPCO, LLC as an opioid treatment/methadone-dispensing program: H0020 shows 3.3M claims with a $17 avg paid/claim for methadone administration and/or provision, and G2067 shows 170.6K claims with a $191 avg paid/claim for a weekly medication-assisted treatment bundle that includes dispensing, counseling, therapy, and toxicology if performed. High volume on both dispensing (H0020) and bundled clinical services (G2067) suggests the clinic both supplies methadone and delivers integrated counseling and monitoring services on a frequent, ongoing basis.

The provider is a dominant statewide player for primary methadone codes: H0020 ranks #1 of 9 providers in-state (100th percentile; notably above typical state volume) and G2067 ranks #1 of 8 providers in-state (100th percentile; notably above typical state volume). G2078 also ranks #1 of 2 providers in-state (100th percentile) but is described as typical volume for that code, reinforcing that this organization leads in both dispensing and bundled treatment services statewide.

One clinical volume outlier is 90791 (psychiatric evaluation): 2.4K claims, $122 avg paid/claim, $291.6K revenue, and it ranks #1 of 89 providers in-state (100th percentile; extreme outlier). This unusually high state rank for psychiatric evaluations indicates the program either integrates initial psychiatric assessments at substantially higher rates than peers or bills for this service at scale relative to other in-state providers, which materially affects the clinical mix beyond dispensing.

Smaller codes reflect ancillary behavioral-health and intake activities but represent only a sliver of revenue: G2074 ($1.7M, 1.8%), G2076 ($658.7K, 0.7%), H2015 ($185.4K, 0.2%), and H2016 ($21.6K, 0.0%) indicate per-week bundles without drug, intake/care planning, and community support services are present but not revenue drivers. The distribution shows operational focus on high-volume dispensing and weekly bundled MAT rather than on per-diem community supports or time-based counseling as primary revenue centers.

HABIT OPCO, LLC has long tenure on the NPI file (enumerated 2008-09-08, ~18 years ago), suggesting established clinic operations and experience in delivering opioid treatment services in the market. That longevity, combined with dominance on core methadone codes, positions the provider as a longstanding specialist in its service line.

Payer concentration creates both leverage and vulnerability: with $94M in Medicaid revenue and no Medicare billing on file, the organization’s financial performance is highly exposed to Medicaid policy, rate changes, and state-level program shifts. The combination of concentrated revenue (97.0% from three codes) and state-level dominance on key methadone codes suggests strong negotiating relevance with Medicaid plans but also a business risk if Medicaid coverage or reimbursement for these specific codes changes.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

10 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)	3,332,600	$20	$56.7M
G2067	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…	170,580	$190	$32.6M
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	54,900	$40	$1.9M
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…	11,340	$150	$1.7M
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…	3,970	$170	$658.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	2,390	$120	$291.6K
H2015	Comprehensive community support services, per 15 minutes	14,260	$10	$185.4K
H2016	Comprehensive community support services, per diem	180	$120	$21.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	90	$50	$4.4K
H0004	Behavioral health counseling and therapy, per 15 minutes	20	$70	$1.2K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.

Claims Volume vs. Vermont Distribution

Habit Opco, LLC — 4 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

10 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	17,110	$40	$13.6M
H2015	Comprehensive community support services, per 15 minutes	15	20	64,230	$90	$7.1M
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	120	$190	$4.1M
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…	1	10	11,340	$150	$1.7M
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	10	27,460	$40	$969.3K
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…	1	10	3,970	$170	$657.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	19	20	1,410	$80	$247.4K
H2016	Comprehensive community support services, per diem	1	10	180	$120	$21.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1	90	60	$50	$9.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	70	110	150	$10	$4.6K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Habit Opco, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Habit Opco, LLC	MA	Methadone Clinic	$11M	$224.1M
Habit Opco, LLC	NJ	Methadone Clinic	$433.4K	$17.4M
Habit Opco, LLC	NH	Methadone Clinic	$539.9K	$4.3M
Habit Opco, LLC	NH	Methadone Clinic	$493.3K	$3.9M
Habit Opco, LLC	VT	Substance Use Disorder Rehabilitation Clinic/Center	$463.1K	$1.5M
Clifton Lord	VT	Addiction Medicine (Internal Medicine) Physician	$42.7K	$0

Habit Opco, LLC — Billing Profile & Reimbursement Data

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Habit Opco, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References