This provider's $4.3M in total Medicare payments ranks in the 97th percentile of Opioid Treatment Program providers nationally.
Medicare payments to this provider grew 382% from 2020 to 2023.
92% of their billing comes from a single procedure code (G2067 — Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 494% in 2021
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2020 | $137.77 | $136.98 | 1.01x | $0.79 | $250.5K | 1.6K | 358 |
| 2021 | $153.17 | $142.96 | 1.07x | $10.21 | $1.5M | 8.3K | 422 |
| 2022 | $149.30 | $138.93 | 1.07x | $10.37 | $1.3M | 7.3K | 466 |
| 2023 | $163.97 | $154.24 | 1.06x | $9.73 | $1.2M | 7.1K | 339 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm | 17.8K | $3.9M | $221.96 | 1.03x |
| 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 | 5.8K | $212.6K | $36.94 | 1.03x |
| 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 by a medicare-enrolled opioid treatment program) | 545 | $93.3K | $171.10 | 1.03x |
| G2077 | Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for | 196 | $23.1K | $117.84 | 1.04x |
| G2076 | Intake activities, including initial medical examination that is a complete, fully documented physical evaluation and initial assessment by a program physician or a primary care physician, or an authorized healthcare professional under the supervision of a | 73 | $11.9K | $162.45 | 1.18x |
This provider submits charges 1.03 times higher than what Medicare actually pays.
A markup ratio of 1.03x means for every $100 Medicare pays, this provider initially charges $103. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Opioid Treatment Program providers in MA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Habit Opco, Llc | Springfield, MA | $46.7M | ✓ Clear |
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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