Agency
Spectrum Health Systems, INC
Spectrum Health Systems, INC was paid $3.81M by Medicaid between Jan 2018 and Dec 2024, across 6 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) — 40% of everything it billed.
33Billing provider infoSPECTRUM HEALTH SYSTEMS, INC
WORCESTER, MA 01605
WORCESTER, MA 01605
33aNPI1346430253assigned 07/26/2007
33bProvider typeCommunity/Behavioral Health Agency
28Total paid$3.81M
24GClaims128,392
24DCodes billed6
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Community/Behavioral Health Agency providers in Massachusetts
Rank by total paid#70 of 169
Median peer was paid$1.37M
This provider vs. median2.8×
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 | 14,152 | $187K | |
| 2019 | 10,407 | $140K | |
| 2020 | 30,118 | $498K | |
| 2021 | 31,467 | $524K | |
| 2022 | 30,135 | $542K | |
| 2023 | 6,708 | $1.06M | |
| 2024incomplete | 5,405 | $857K |
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) | 40% | 110,744 | 5,537 | $1.53M |
| 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) | 40% | 7,942 | 3,102 | $1.51M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 12% | 5,019 | 4,643 | $462K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 5.4% | 4,064 | 3,698 | $206K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 2.4% | 578 | 575 | $90K |
| 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% | 45 | 32 | $7K |
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 officialLANGLOIS, JANET (CFO/TREASURER)
Parent organizationSPECTRUM HEALTH SYSTEMS, INC