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NPI 1912233826 · Portland, ME · Substance Use Disorder Rehabilitation Clinic/Center
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Merrimack River Medical Services, Inc. is a substance use disorder rehabilitation clinic/center provider located in Portland, Maine. This profile covers 1 Medicare and 6 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 | Merrimack River Medical Services, Inc. |
| Address | 2300 Congress St |
| City | Portland |
| State | ME |
| ZIP | 04102 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | October 28, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.6M |
| Medicare | $253.7K |
MERRIMACK RIVER MEDICAL SERVICES, INC. is a substance use disorder rehabilitation clinic in PORTLAND, ME (NPI enumerated 2009-10-28, ~17 years ago). Its billing profile and code mix indicate a clinic structured around opioid treatment program services, with methadone administration and bundled medication-assisted treatment as the operational core.
Medicare revenue is small relative to Medicaid: total Medicare revenue is $253.7K while total Medicaid revenue is $4.6M, indicating this site is effectively Medicaid-dominant in scale. Despite the presence of Medicare billing, Medicaid drives the majority of lifetime revenue for this provider.
Medicare revenue is concentrated entirely in the single code G2067, which is listed as generating $253.8K and is reported to account for 100.0% of this provider's Medicare revenue. The Medicare average paid per claim for G2067 is $228 across 1.1K claims, and the code’s national standing is #211 of 830 providers (75th percentile), described in the source as typical, unremarkable volume for this code.
Medicaid revenue is highly concentrated in H0020: H0020 accounts for $4.6M and represents 98.8% of the provider’s Medicaid revenue, and the top 3 Medicaid codes are reported to account for 100.0% of Medicaid revenue. The H0020 record shows 54.4K claims at an average paid per claim of $84, indicating a high-volume methadone administration operation under Medicaid.
The Medicaid portfolio shows a secondary Medicaid presence of G2067 (8.9K claims, $53.4K revenue, 1.2% of Medicaid revenue) and isolated low-dollar counseling entries such as H0004 (29 claims, $841 revenue). These secondary lines suggest the clinic focuses on dispensing and medication administration rather than high-revenue ancillary psychotherapy or extended case-management services.
Competitive standing: for its Medicare specialty service G2067 the provider ranks #211 of 830 nationally (75th percentile) — a typical, unremarkable national volume rather than a dominant national position. On Medicaid, H0020 ranks #8 of 14 in-state (46th percentile) and the provider’s Medicaid G2067 ranks #5 of 12 in-state (64th percentile), both characterized as typical, unremarkable volumes, indicating a modest to mid-level presence in the Maine market rather than market leadership.
Payer-level reimbursement patterns highlight different economics: Medicare G2067 pays an average of $228 per claim while Medicaid pays an average of $84 per claim for H0020 and only $6 per claim for Medicaid G2067. This gap, combined with 54.4K H0020 claims, implies the provider’s Medicaid-driven throughput is high-volume but lower-paid per encounter compared with its Medicare billing.
Operational implication: the combination of H0020 and G2067 as the dominant codes (together accounting for essentially all Medicaid and Medicare revenue per the top-3 shares) signals that the clinic’s business model centers on methadone-based medication assisted treatment and on-site dispensing/administration services typical of an opioid treatment program. The claim counts and code mix support a high-throughput dispensing operation rather than a broad outpatient behavioral-health practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 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… | 1,110 | $230 | $253.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G2067 | 6 | 10 | 1,110 | $230 | $263K |
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.
6 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) | 54,380 | $80 | $4.6M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 8,900 | $10 | $53.4K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 30 | $30 | $840 |
| 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 | 400 | $0 | $0 |
| H2010 | Comprehensive medication services, per 15 minutes | 90 | $0 | $0 |
| T2022 | Case management, per month | 1,220 | $0 | $0 |
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
6 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) | 8 | 10 | 61,180 | $110 | $9.2M |
| H2010 | Comprehensive medication services, per 15 minutes | 46 | 50 | 3,690 | $130 | $1.6M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 285 | 290 | 860 | $80 | $805.1K |
| T2022 | Case management, per month | 15 | 40 | 800 | $190 | $780.3K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 5 | 10 | 5,260 | $10 | $78.6K |
| 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 | 9 | 10 | 950 | $1 | $6.5K |
Other providers in the same ZIP code as Merrimack River Medical Services, Inc., ranked by combined Medicare and Medicaid revenue.
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