Loading...
NPI 1992043053 · Cincinnati, OH · Substance Use Disorder Rehabilitation Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Sunrise Treatment Center, LLC is a substance use disorder rehabilitation clinic/center provider located in Cincinnati, Ohio. This profile covers 4 Medicare and 68 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 | Sunrise Treatment Center, LLC |
| Address | 6460 Harrison Ave |
| City | Cincinnati |
| State | OH |
| ZIP | 45247 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | January 24, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $130.1M |
| Medicare | $235.8K |
SUNRISE TREATMENT CENTER, LLC’s Medicare billing is almost entirely concentrated in medication-assisted treatment bundles: G2068, G2079, and G2074 together account for 99.5% of the provider's Medicare revenue. Those codes describe weekly MAT bundles, take-home buprenorphine supplies, and MAT weekly bundles without drug, indicating the Medicare activity is focused on OTP-style maintenance care rather than diverse outpatient primary care services.
Medicaid revenue is similarly concentrated but across a mixture of administration and dispensing: T1502, S5000, and S5001 make up 67.1% of the provider’s Medicaid revenue. T1502 (administration of medication) and S5000 (prescription drug, generic) each deliver roughly one-third of Medicaid revenue, which points to a business model that mixes on-site medication administration with high-volume prescription dispensing.
The payer mix is heavily skewed toward Medicaid: the provider reported Total Medicare revenue of $235.8K versus Total Medicaid revenue of $130.1M, indicating the organization is functionally Medicaid-dominant in scale and likely relies on state programs and fee schedules for the bulk of its cash flow. This scale difference suggests Medicaid policy or network changes would have a much larger financial impact than Medicare changes.
Competitively, the provider is a modest national participant in Medicare MAT codes — for example, G2068 ranks #3 of 13 nationally (83th percentile; typical, unremarkable volume) and G2074 ranks #43 of 179 (76th percentile; typical, unremarkable volume) — consistent with a niche OTP presence in the Medicare market. By contrast, SUNRISE is a major statewide operator on Medicaid for several services: it ranks #1 for H0004 of 248 providers (100th percentile; extreme outlier), #1 for J0574 of 36 providers (100th percentile; extreme outlier), and #1 for J0572 of 17 providers (100th percentile; extreme outlier), signaling clear dominance in those treatment and dispensing lines within Ohio.
Operationally, the provider bills very high volumes of drug testing and specimen collection codes across Medicaid — H0048 has 250.5K claims and is described as an extreme outlier, while G0482 (30.9K claims) and G0480 (32.8K claims) are also high-volume definitive testing codes. This mix (collection plus definitive testing) implies an integrated workflow that pairs MAT dispensing with routine and confirmatory toxicology services, and suggests substantial investment in specimen handling and laboratory coordination.
Clinical breadth extends beyond medication dispensing into counseling and psychotherapy: H0004 (94.2K claims, behavioral health counseling and therapy) ranks #1 in-state and is an extreme outlier, and psychotherapy codes 90837, 90834, and 90832 each appear with tens of thousands of claims. Together with H0015 (intensive outpatient) and H0005 (group counseling), the profile indicates SUNRISE operates both medication-based maintenance and structured behavioral treatment tracks, consistent with comprehensive SUD program models.
Revenue concentration creates operational sensitivity: Medicare revenue is almost entirely dependent on three OTP bundle codes (99.5%), and Medicaid revenue has 67.1% concentration in three administration/dispensing codes. That degree of concentration suggests the provider’s financial performance is closely tied to the reimbursement and utilization of a small set of MAT and dispensing services, making it susceptible to coding, policy, or pricing shifts that affect those specific codes.
The provider has an established footprint with an NPI enumerated on 2013-01-24 (~13 years ago), and the combination of tenure plus the extremely high state rankings on multiple Medicaid codes implies a mature, scaled operation in Ohio’s SUD treatment ecosystem rather than a newly formed clinic. This longevity likely contributed to the build-out of high-volume dispensing, testing, and counseling workflows reflected in the billing mix.
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 |
|---|---|---|---|---|
| G2068 | Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if… | 570 | $270 | $154.4K |
| G2079 | Take-home supply of buprenorphine (oral); 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… | 660 | $80 | $51.7K |
| 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… | 160 | $180 | $28.5K |
| 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… | 10 | $110 | $1.2K |
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.
68 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | 254,670 | $160 | $40.2M |
| S5000 | Prescription drug, generic | 300,390 | $130 | $40M |
| S5001 | Prescription drug, brand name | 26,430 | $230 | $6M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 94,160 | $60 | $5.5M |
| 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… | 41,210 | $120 | $4.8M |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 92,650 | $40 | $4.1M |
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including… | 24,180 | $170 | $4M |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 38,540 | $100 | $3.9M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 30,860 | $120 | $3.7M |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 250,480 | $10 | $3.5M |
Showing 1–10 of 68
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
68 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| S5000 | Prescription drug, generic | 2 | 20 | 2,720 | $150 | $7.7M |
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | 2 | 40 | 2,350 | $140 | $4.4M |
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including… | 80 | 610 | 1,350 | $150 | $1.9M |
| S5001 | Prescription drug, brand name | 2 | 10 | 2,720 | $50 | $1.5M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4 | 80 | 910 | $110 | $884.9K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 1 | 40 | 5,650 | $20 | $435.4K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 69 | 2,640 | 620 | $90 | $408.2K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 7 | 340 | 2,260 | $30 | $398.2K |
| 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… | 117 | 4,510 | 500 | $60 | $377.8K |
| 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… | 1,637 | 5,080 | 560 | $40 | $323.9K |
Showing 1–10 of 68
Other providers in the same ZIP code as Sunrise Treatment Center, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Green Township Trustees | OH | Ambulance | $450.6K | $831.4K |
| Beacon Orthopaedics Surgery Center, LLC | OH | Ambulatory Surgical Clinic/Center | $1.1M | $0 |
| Robert Rolf | OH | Orthopaedic Surgery Physician | $303.1K | $0 |
| Haleem Chaudhary | OH | Orthopaedic Surgery Physician | $288K | $0 |
| Matthew Johansen | OH | Adult Reconstructive Orthopaedic Surgery Physician | $278.4K | $0 |
| Robert Burger | OH | Sports Medicine (Orthopaedic Surgery) Physician | $188.5K | $0 |
| Christopher Mcpherson | OH | Neurological Surgery Physician | $185K | $0 |
| Glen Mcclung | OH | Sports Medicine (Orthopaedic Surgery) Physician | $126.7K | $0 |
| Brandon Modafari | OH | Physical Therapist | $115.7K | $0 |
| John Brannan | OH | Pain Medicine (Physical Medicine & Rehabilitation) Physician | $114.9K | $0 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.