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NPI 1912980251 · Westfield, MA · Substance Use Disorder Rehabilitation Clinic/Center
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Community Health Care, Inc. is a substance use disorder rehabilitation clinic/center provider located in Westfield, Massachusetts. This profile covers 4 Medicare and 9 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 | Community Health Care, Inc. |
| Address | 130 Southampton Rd |
| City | Westfield |
| State | MA |
| ZIP | 01085 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | November 21, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $127.2M |
| Medicare | $5.1M |
COMMUNITY HEALTH CARE, INC. functions operationally as an opioid treatment program with a service mix dominated by medication‑assisted treatment and methadone dispensing: Medicare top codes are led by G2067 (medication assisted treatment, methadone weekly bundle) which generates $4.8M and 95.9% of this provider's Medicare revenue, and Medicaid top codes include H0020 (methadone administration) with $70.4M and G2067 with $52.4M, reflecting on‑site dispensing plus counseling, group therapy, and toxicology testing as core services. These billing patterns (H0020, G2067, H0004, G2074) indicate a high-volume, clinic‑based substance use disorder treatment operation focused on ongoing methadone maintenance and associated behavioral services rather than brief episodic care.
Revenue concentration is extreme for both payers: the precomputed top‑3 Medicare codes account for 100.0% of Medicare revenue, meaning Medicare billing is almost entirely captured by three OTP‑related codes, and the precomputed top‑3 Medicaid codes account for 98.3% of Medicaid revenue, indicating Medicaid receipts are likewise highly concentrated in a very small set of methadone and counseling codes. This concentration suggests most clinical activity billable to these programs falls into recurring, standardized OTP service bundles rather than a dispersed portfolio of procedure types.
Payer mix is heavily skewed toward Medicaid: lifetime Medicaid revenue of $127.2M far exceeds lifetime Medicare revenue of $5.1M, so the provider is effectively Medicaid‑dominant in scale and volume. Analysts should treat Medicare activity as a much smaller slice of the business footprint while focusing competitive and utilization analysis primarily on Medicaid flows and state program dynamics.
On Medicare competitive standing, COMMUNITY HEALTH CARE, INC. is a national outlier for core OTP billing: G2067 ranks #3 of 830 providers nationally and is labeled an "extreme outlier," and G2074 ranks #2 of 179 (99th percentile, "notably above typical"). Those placements indicate the provider operates at volumes far above typical national peers for Medicare OTP bundles, positioning it as a major national volume contributor for those specific codes. By contrast, its Medicare G2078 activity (rank #18 of 493, 97th percentile) is described as typical/unremarkable, showing the extreme dominance is concentrated in the primary treatment bundles.
Within Massachusetts Medicaid, the provider is a leading in‑state supplier of methadone services: H0020 ranks #3 of 38 providers in the state (95th percentile, "notably above typical"), and G2067 ranks #3 of 31 (93th percentile, "notably above typical"). Multiple OTP codes (H0004, G2074, G2078) also sit at high state percentiles (92th–90th) which collectively signal major market share in Medicaid OTP services across clinical and counseling lines rather than a fringe or occasional provider.
Several individual codes are flagged as statistical outliers or notably high volume and should be prioritized for benchmarking: Medicare G2067 is an "extreme outlier" nationally, and Medicaid H0020 and G2067 are both described as "notably above typical" in‑state. Those labels, combined with the high claim counts reported (e.g., 5.4M H0020 claims on Medicaid and 377.1K G2067 claims on Medicaid), indicate unusually large, sustained dispensing and treatment throughput relative to peers and merit closer operational benchmarking and capacity review.
The provider’s service mix includes substantial behavioral counseling alongside medication dispensing: Medicaid shows H0004 (behavioral health counseling, per 15 minutes) with $1.9M (1.5% of Medicaid revenue) and H0005 (group counseling) among top Medicaid codes, confirming that individual and group therapy are billed alongside medication bundles. This mix implies integrated counseling resources and supports care models that combine pharmacotherapy with psychotherapy and group interventions, not solely medication dispensing.
Tenure and stability signals are consistent with a well‑established program: the NPI was enumerated on 2005-11-21 (~21 years ago), which aligns with the scale of cumulative Medicaid and Medicare billing reported. For payers and network planners, the long tenure plus concentrated, high-volume OTP billing suggests an entrenched service provider in the regional substance use treatment landscape.
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… | 19,540 | $250 | $4.8M |
| 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… | 690 | $210 | $143.2K |
| 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 | 1,660 | $40 | $64.9K |
| G2172 | All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project | 10 | $120 | $1.6K |
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.
9 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) | 5,417,330 | $10 | $70.4M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 377,130 | $140 | $52.4M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 37,090 | $50 | $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… | 8,980 | $120 | $1.1M |
| 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 | 25,300 | $30 | $784.4K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 11,920 | $20 | $262.3K |
| H2015 | Comprehensive community support services, per 15 minutes | 1,940 | $10 | $21.4K |
| 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… | 170 | $130 | $21.4K |
| 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… | 890 | $1 | $890 |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
9 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) | 3 | 40 | 26,400 | $10 | $9.7M |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 3 | 30 | 8,280 | $140 | $8M |
| H2015 | Comprehensive community support services, per 15 minutes | 92 | 150 | 7,770 | $140 | $4.8M |
| 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… | 2 | 10 | 1,140 | $90 | $518.2K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 3 | 30 | 3,380 | $50 | $460K |
| 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 | 20 | 1,680 | $30 | $408.3K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 3 | 20 | 2,320 | $20 | $244.9K |
| 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… | 7 | 10 | 200 | $140 | $157.9K |
| 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… | 2 | 10 | 230 | $10 | $5.3K |
Other providers in the same ZIP code as Community Health Care, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Baystate Noble Hospital Corporation | MA | General Acute Care Hospital | $0 | $21.9M |
| Department Of Mental Health | MA | Case Management Agency | $0 | $6.4M |
| City Of Westfield | MA | Land Ambulance | $883.7K | $3.1M |
| Lance Reynolds | MA | Internal Medicine Physician | $318.4K | $116.7K |
| Sarah Bashiruddin | MA | Internal Medicine Physician | $303.8K | $20.5K |
| John Thayer | MA | Ophthalmology Physician | $298K | $6.6K |
| Akinyele Lovelace | MA | Internal Medicine Physician | $239.6K | $32.4K |
| Brian Paul Sutton | MA | Emergency Medicine Physician | $47.9K | $214.2K |
| Ram Malladi | MA | Otolaryngology Physician | $217.3K | $0 |
| Mehdi Pajouh | MA | Cardiovascular Disease Physician | $163.4K | $25.7K |
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