Spectrum Health Care, INC.

Spectrum Health Care, INC. was paid $16.85M by Medicaid between Jan 2018 and Dec 2024, across 15 billing codes. Its largest line is 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) — 50% of everything it billed.

Compared with peers

Next to other Methadone Clinic providers in New Jersey

Rank by total paid#5 of 33

Median peer was paid$4.86M

This provider vs. median3.5×

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	19,410	$1.71M
2019	18,539	$1.79M
2020	19,461	$1.83M
2021	24,310	$2.17M
2022	33,152	$2.75M
2023	32,033	$3.32M
2024incomplete	26,182	$3.27M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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)	50%	80,744	21,592	$8.51M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	33%	61,756	15,254	$5.57M
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 assessment, counseling; crisis intervention, and activity therapies or education	9.6%	14,454	2,323	$1.61M
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	2.2%	842	836	$368K
90792	Psychiatric diagnostic evaluation with medical services	1.8%	768	757	$311K
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%	5,926	3,312	$142K
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	<1%	1,446	1,442	$129K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	2,377	2,014	$119K
H0033	Oral medication administration, direct observation	<1%	186	58	$35K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	1,393	1,390	$22K
86580		<1%	2,721	2,575	$11K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	<1%	81	81	$6K

3 more codes

87426	Infectious agent antigen detection, SARS-CoV-2 (COVID-19)	<1%	118	$5K
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%	248	$4K
99213	Doctor's office visit, returning patient (routine)	<1%	27	$921.50

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 officialCOX, EDWARD (EXECUTIVE DIRECTOR)