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 Delaware for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Delaware 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. Delaware (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.

Banyan Delaware LLC (NPI 1316579634)

Field	Value
Entity Type	Organization
Organization	Banyan Delaware LLC
Address	21 W Clarke Ave Ste 4001
City	Milford
State	DE
ZIP	19963
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	February 5, 2020

Payer Source	Total Paid
Medicaid	$30.9M
Medicare	$0

Key Findings

BANYAN DELAWARE LLC’s coding profile is centered on substance use disorder treatment: its largest Medicaid revenue drivers are H2036 (Alcohol and/or other drug treatment program, per diem), H0010 (sub-acute detoxification, residential), and H0015 (intensive outpatient treatment). The mix of a high-volume per-diem code (H2036) alongside residential detox (H0010) and structured outpatient programming (H0015) indicates the facility operates both residential and outpatient addiction treatment programs rather than focusing solely on brief office-based services.

Revenue is highly concentrated: the top 3 Medicaid codes by revenue account for 93.6% of this provider’s total Medicaid revenue, with H2036 generating $22.5M (72.7% of Medicaid revenue), H0010 generating $5M (16.2%), and H0015 generating $1.4M (4.7%). This concentration means most financial activity is tied to a small set of modality-specific services.

BANYAN DELAWARE is effectively a single-payer Medicaid provider: total Medicaid revenue is $30.9M while there is none below for Medicare — this provider has no Medicare billing on file. The lack of Medicare activity implies payer and utilization dynamics will be dominated by Medicaid policy, rates, and authorization practices.

On state competitive standing, BANYAN DELAWARE is a dominant provider for certain services: H2036 ranks #1 of 9 providers in-state and sits at the 100th percentile with a label of "notably above typical state volume for this code," and H0010 is listed as #1 of 1 provider in-state (no state peer volume comparison available), indicating it is either unique or the sole reported biller for sub-acute residential detox in Delaware. H0015 ranks #4 of 16 (80th percentile), showing it is a solid, above-average provider for intensive outpatient services but not uniquely dominant.

Top-code operational footprint is visible in claim counts and unit payments: H2036 had 70.6K claims at $318 avg paid/claim, H0010 had 9.1K claims at $550 avg paid/claim, and H0015 had 8.8K claims at $164 avg paid/claim. The combination of very high claim volume for a per-diem code (H2036) with a higher per-claim payment for inpatient detox (H0010) suggests revenue is driven by both volume-based residential days and relatively higher-priced detox episodes.

The provider also shows unusually high state-level volume for some ancillary behavioral health services: 96130 ranks #1 of 8 providers in-state (100th percentile; notably above typical state volume for this code) with $245.2K revenue, and several codes appear as sole in-state billers (for example, T1023, 90876, T1016, H0002, and 99409 are each listed #1 of 1 with no state peer comparison available). This pattern indicates BANYAN DELAWARE offers a broader menu of assessment, biofeedback, screening, and case-management-type services that other in-state providers report less frequently.

Given the concentration into a few modality-specific codes, payers and network managers should prioritize oversight and contracting attention on residential per-diem and detox services (H2036 and H0010) when assessing utilization and rate adequacy. Those two codes alone represent the overwhelming share of Medicaid dollars for this entity and therefore drive most risk and leverage in payer negotiations.

The provider’s NPI was enumerated on 2020-02-05 (~6 years ago), indicating a relatively recent market presence; despite that shorter tenure it has established large Medicaid volumes quickly, particularly for H2036 where it reports 70.6K claims and ranks at the top of state peers. This rapid build-out of high-volume residential billing may be relevant for trend monitoring and capacity assessments in the state behavioral health system.

Medicaid: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	70,630	$320	$22.5M
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	9,110	$550	$5M
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…	8,790	$160	$1.4M
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	1,410	$370	$527K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	530	$870	$455.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	2,180	$120	$255.2K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	2,700	$90	$245.2K
99409	The provider spends more than 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.	2,550	$50	$130.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	740	$130	$92.7K
96156	The provider assesses psychological, behavioral, emotional, cognitive, and social factors that affect a patient’s physical health, rather than assessing a specific mental health disorder. There are…	910	$70	$59K

Showing 1–10 of 27

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Banyan Delaware LLC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0010	Alcohol and/or drug services; sub‑acute detoxification (residential addiction program inpatient)	1	10	9,110	$550	$5M
H2036	Alcohol and/or other drug treatment program, per diem	1	10	4,900	$250	$2.8M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	1	10	530	$870	$455.6K
H0011	Alcohol and/or drug services; acute detoxification (hospital inpatient) per diem	2	10	1,410	$190	$390.3K
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…	4	20	1,500	$90	$361K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	73	240	700	$60	$205.6K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	9	20	280	$50	$188.3K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	54	80	790	$40	$180.4K
99409	The provider spends more than 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.	1	10	2,550	$50	$128.9K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	22	30	690	$50	$128.4K

Showing 1–10 of 27

Nearby Providers

Other providers in the same ZIP code as Banyan Delaware LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$39.5M
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$28.5M
Epic Health Services (de), LLC	DE	Home Health Agency	$0	$19.3M
Delaware Pediatric Dentistry	DE	Pediatric Dentistry	$0	$18.1M
Kent-sussex Industries	DE	Developmentally Disabled Services Day Training Agency	$0	$11.7M
Nurses 'n Kids Of Milford, Inc.	DE	Medically Fragile Infants and Children Day Care	$0	$9.5M
Prn Staffers Inc	DE	Home Health Agency	$0	$7.6M
People's Place Ii, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.9M
Bayhealth Medical Center, Inc.	DE	Clinic/Center	$0	$3.7M
La Red Health Center, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$2.7M

Banyan Delaware LLC — Billing Profile & Reimbursement Data

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Banyan Delaware 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