This provider's $6.9M in total Medicare payments ranks in the 98th percentile of Opioid Treatment Program providers nationally.
Medicare payments to this provider grew 1183% from 2018 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 149% in 2020
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 |
|---|---|---|---|---|---|---|---|
| 2018 | $288.25 | $144.49 | 1.99x | $143.76 | $166.4K | 1.5K | 258 |
| 2019 | $215.00 | $109.65 | 1.96x | $105.35 | $346.4K | 3.5K | 575 |
| 2020 | $231.26 | $153.84 | 1.50x | $77.42 | $862.8K | 6.4K | 1.3K |
| 2021 | $238.03 | $152.49 | 1.56x | $85.54 | $1.5M | 10.7K | 1.9K |
| 2022 | $240.18 | $152.46 | 1.58x | $87.72 | $1.8M | 13.7K | 2.3K |
| 2023 | $248.50 | $164.56 | 1.51x | $83.94 | $2.1M | 14.2K | 2.1K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| G2068 | Medication assisted treatment, buprenorphine (oral); 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 opi | 8.8K | $2.2M | $252.99 | 1.13x |
| 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 | 8.6K | $923.5K | $107.52 | 1.10x |
| 80307 | Testing for presence of drug | 14.6K | $904.6K | $62.00 | 1.45x |
| G0483 | 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 not limited to gc/ms (any type, single or tandem) and lc/ms | 3.4K | $823.5K | $243.34 | 1.97x |
| 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 not limited to gc/ms (any type, single or tandem) and lc/ms | 3.5K | $677.8K | $195.89 | 2.04x |
| G0481 | 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 not limited to gc/ms (any type, single or tandem) and lc/ms | 3.2K | $488.6K | $153.90 | 2.08x |
| 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 procedure | 4.5K | $355.9K | $79.78 | 1.20x |
| G0480 | 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 not limited to gc/ms (any type, single or tandem) and lc/ms | 2.0K | $222.1K | $112.58 | 2.09x |
| 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) | 1.2K | $201.6K | $162.56 | 1.16x |
| 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 | 228 | $52.7K | $231.11 | 1.16x |
| 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 | 176 | $29.8K | $169.14 | 1.08x |
This provider submits charges 1.46 times higher than what Medicare actually pays.
A markup ratio of 1.46x means for every $100 Medicare pays, this provider initially charges $146. This is lower than the national average.
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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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