Habit Opco, LLC

Habit Opco, LLC was paid $224.15M by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is H0020, Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) — 53% of everything it billed.

33Billing provider infoHABIT OPCO, LLC
SPRINGFIELD, MA 01105

33aNPI1023175072assigned 01/02/2007

33bProvider typeCase Management Agency

28Total paid$224.15M

24GClaims9,635,556

24DCodes billed28

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Case Management Agency providers in Massachusetts

Rank by total paid#23 of 139

Median peer was paid$11.53M

This provider vs. median19×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	1,813,447	$25.30M
2019	1,833,282	$25.72M
2020	1,806,455	$25.24M
2021	1,565,238	$31.79M
2022	1,655,421	$35.34M
2023	558,404	$42.76M
2024incomplete	403,309	$38.01M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	53%	8,438,595	389,288	$117.74M
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 treatment program)	29%	534,453	151,290	$63.97M
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	6.8%	130,680	34,163	$15.30M
G9012	Other specified case management service not elsewhere classified	4.8%	40,063	39,839	$10.70M
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	1.7%	180,009	82,591	$3.87M
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)	1.5%	45,545	23,967	$3.40M
H0004	Behavioral health counseling and therapy, per 15 minutes	<1%	38,703	24,238	$2.05M
H0005	Alcohol and/or drug services; group counseling by a clinician	<1%	107,814	37,169	$1.74M
90853	Group psychotherapy (other than of a multiple-family group)	<1%	40,296	18,894	$1.38M
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 standardized, evidence-based assessment, and that includes the patient's goals and mutually agreed-upon actions for the patient to meet those goals, including harm reduction interventions; the patient's needs and goals in the areas of education, vocational training, and employment; and the medical and psychiatric, psychosocial, economic, legal, housing, physical activity and/or nutrition needs and other recovery support services that a patient needs and wishes to pursue, conducted by an appropriately licensed/credentialed personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to each primary code	<1%	7,760	7,708	$1.10M
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	<1%	26,161	15,825	$1.07M
90792	Psychiatric diagnostic evaluation with medical services	<1%	2,583	2,001	$500K

16 more codes

90834	Psychotherapy session, about 45 minutes	<1%	4,071	$359K
90791	Psychiatric diagnostic evaluation	<1%	2,030	$232K
90837	Psychotherapy session, about an hour	<1%	1,704	$183K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	1,818	$113K
H2015	Community support for mental illness or disability, per 15 minutes	<1%	6,595	$90K
H0034	Medication training and support, per 15 minutes	<1%	1,108	$84K
99213	Doctor's office visit, returning patient (routine)	<1%	1,151	$82K
J0574	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	<1%	7,717	$51K
J0575	Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine	<1%	3,437	$36K
H2016	Community support for mental illness or disability, billed per day	<1%	274	$27K
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 patient-identified goals, and other relevant physical, nutrition and psychiatric treatment needs and goals; may be informed by administration of a standardized, evidence-based assessment, or the need and interest for harm reduction interventions and recovery support services (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to each primary code	<1%	2,377	$25K
J0572	Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine	<1%	5,606	$15K
H0001	Alcohol and/or drug assessment	<1%	141	$9K
J0573	Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine	<1%	2,234	$8K
J0571	Buprenorphine, oral, 1 mg	<1%	2,583	$4K
99215	Doctor's office visit, returning patient (complex)	<1%	48	$3K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialCATES, LAURA (CREDENTIALING MANAGER)

Parent organizationACADIA HEALTHCARE