Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Maine for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Maine only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Maine (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Brighter Heights Maine, LLC (NPI 1013223361)

Field	Value
Entity Type	Organization
Organization	Brighter Heights Maine, LLC
Address	70 Bayview St
City	Yarmouth
State	ME
ZIP	04096
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	August 25, 2010

Payer Source	Total Paid
Medicaid	$27.8M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operation: there is no Medicare billing on file and total Medicaid revenue is $27.8M, indicating a single-payer footprint concentrated in state Medicaid programs rather than a mixed Medicare/Medicaid business model. Analysts should treat Medicare-driven comparisons as not applicable for this entity.

Revenue is highly concentrated in a very small set of service lines: the precomputed top 3 Medicaid codes by revenue account for 77.7% of total Medicaid revenue, led by H2021 at $10.9M (39.0% of Medicaid revenue), followed by T2016 at $8.5M (30.6%) and H2017 at $2.2M (8.0%). This concentration means changes in reimbursement policy or utilization for these three codes would materially move the provider’s financials.

The code mix signals a services model centered on intensive, ongoing behavioral and residential supports: H2021 (Community-based wrap-around services, per 15 minutes) and H2017 (Psychosocial rehabilitation services, per 15 minutes) point to time-based outpatient/community treatment, while T2016 (Habilitation, residential, waiver; per diem) indicates substantial residential habilitation operations. Together these codes suggest staffing- and facility-intensive programming for populations needing continuous supports rather than episodic medical care.

Claim-volume metrics underline operational scale in those service lines: H2021 shows 59.7K claims, T2016 shows 17.6K claims, and H2017 shows 22.3K claims, consistent with high-frequency, time- or day-based billing rather than low-volume procedure billing. Those claim counts support the interpretation that this is a high-utilization behavioral health and residential habilitation provider.

Competitive standing is mixed by service line: for H2021 the provider ranks #6 of 104 providers in-state (95th percentile) and is described as notably above typical state volume for this code, indicating a strong, possibly market-leading position in community-based wrap-around services. By contrast, T2016 ranks #20 of 75 (74th percentile) and H2017 ranks #5 of 15 (71th percentile), both characterized as typical or unremarkable volumes, so the provider is a major player for H2021 but more of a modest participant for other top services.

Outside the top three, revenue is spread across many supplemental behavioral-health codes at much smaller shares: examples include H0004 $984.1K (3.5%), H2012 $971.8K (3.5%), and T2022 $861.4K (3.1%), which together account for meaningful secondary revenue but do not offset the dominance of the top three codes. Telehealth billing is minimal (Q3014 $1.4K), suggesting limited use of telehealth as a revenue channel in the observed period.

The provider has an established enrollment history — NPI enumerated 2010-08-25 (~16 years ago) — which, combined with its concentrated Medicaid revenue and high ranking on H2021, indicates a sustained, specialized presence in Maine’s behavioral health/residential habilitation market rather than a recent entrant or a broadly diversified multi-payer provider.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2021	Community-based wrap-around services, per 15 minutes	59,670	$180	$10.9M
T2016	Habilitation, residential, waiver; per diem	17,650	$480	$8.5M
H2017	Psychosocial rehabilitation services, per 15 minutes	22,300	$100	$2.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	11,580	$90	$984.1K
H2012	Behavioral health day treatment, per hour	5,140	$190	$971.8K
T2022	Case management, per month	2,690	$320	$861.4K
H2010	Comprehensive medication services, per 15 minutes	5,210	$150	$791.8K
G9012	Other specified case management service not elsewhere classified	10,640	$70	$765.9K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	2,740	$260	$700.9K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	2,760	$250	$685.2K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maine Distribution

Brighter Heights Maine, LLC — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	20	80	7,300	$1,670	$30.8M
H2021	Community-based wrap-around services, per 15 minutes	6	100	8,660	$290	$5.1M
H2012	Behavioral health day treatment, per hour	33	40	13,180	$230	$5.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	5	20	16,420	$120	$3.6M
G9012	Other specified case management service not elsewhere classified	33	50	25,820	$80	$3M
H2010	Comprehensive medication services, per 15 minutes	17	50	3,690	$130	$1.6M
H0004	Behavioral health counseling and therapy, per 15 minutes	44	290	860	$80	$805.1K
T2022	Case management, per month	7	40	800	$190	$780.3K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	3	30	750	$240	$312.9K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	3	30	740	$240	$301.1K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Brighter Heights Maine, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brighter Heights Maine, LLC	ME	Home Health Agency	$0	$4M
Dirigo Pediatric Dentistry	ME	Pediatric Dentistry	$0	$3.7M
Ankle And Foot Associates PC	ME	Foot & Ankle Surgery Podiatrist	$0	$953.5K
Town Of Yarmouth	ME	Land Ambulance	$99.2K	$70.6K
Christopher Pingitore	ME	Foot & Ankle Surgery Podiatrist	$130.1K	$0
Molly O'malley	ME	Family Medicine Physician	$58.4K	$0
Daniel Pierce	ME	Family Medicine Physician	$54.9K	$0
Nathaniel Anderson	ME	Gerontology Nurse Practitioner	$51.8K	$0
Anthony Bustamante	ME	Family Medicine Physician	$51.6K	$0
Barry White	ME	Foot & Ankle Surgery Podiatrist	$39.5K	$0

Brighter Heights Maine, LLC — Billing Profile & Reimbursement Data

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Brighter Heights Maine, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References