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NPI 1346320983 · Wilmington, DE · Adult Mental Health Clinic/Center
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Brandywine Counseling & Community Services, Inc. is a adult mental health clinic/center provider located in Wilmington, Delaware. This profile covers 4 Medicare and 35 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Brandywine Counseling & Community Services, Inc. |
| Address | 2713 Lancaster Ave |
| City | Wilmington |
| State | DE |
| ZIP | 19805 |
| Taxonomy | Adult Mental Health Clinic/Center |
| NPI Enumerated | October 17, 2006 |
| NPI Deactivated | August 30, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $23.9M |
| Medicare | $170.8K |
This provider is effectively Medicaid-focused: total Medicaid revenue is $23.9M versus total Medicare revenue of $170.8K, indicating the vast majority of its billing and revenue comes from Medicaid rather than Medicare. The scale difference implies business decisions, staffing and service capacity are likely optimized for Medicaid populations and programs rather than fee-for-service Medicare lines.
Revenue concentration is high on a small number of codes for each payer. The top three Medicare codes account for 92.7% of this provider's Medicare revenue, driven largely by opioid treatment program bundles, while the top three Medicaid codes account for 78.1% of Medicaid revenue, dominated by methadone administration and high-volume counseling codes.
Medicare billing is concentrated in opioid treatment program services: G2067, G2078, and G2074 together make up the bulk of Medicare revenue. These codes map to weekly methadone bundles, take-home methadone supplies, and non-drug weekly MAT bundles, which indicates the provider’s Medicare activity is centered on opioid use disorder treatment rather than general psychiatry or medical E/M visits.
Despite small absolute Medicare revenue, the provider’s Medicare rank positions are mixed and generally typical: G2067 is ranked #414 of 830 (50th percentile; typical, unremarkable volume), G2078 is ranked #34 of 493 (93th percentile; typical, unremarkable volume), and G2074 is ranked #46 of 179 (74th percentile; typical, unremarkable volume). In plain terms, the provider participates in national OTP billing at volumes that are generally unremarkable for these codes, so it is not a dominant national Medicare player.
On Medicaid, the provider is a major in-state participant for methadone administration and several ancillary services. H0020 (methadone administration) represents $15.5M or 67.9% of Medicaid revenue and ranks #2 of 13 in-state (92th percentile; notably above typical state volume), and H0038 (self-help/peer services) ranks #1 of 15 in-state (100th percentile; notably above typical state volume), signaling leadership in state-funded OUD treatment capacity.
The Medicaid code mix shows a broad operational footprint around substance use disorder care: large volumes of H0020 (2.2M claims), H0048 (78.2K claims for drug testing), J0574 (61.2K claims for buprenorphine/naloxone), and H0004 (30.7K claims for behavioral counseling) indicate integrated medication administration, frequent toxicology testing, medication management, and substantial counseling capacity. Together these codes suggest a clinic model offering methadone maintenance, medication-assisted treatment, regular testing, and both individual and group therapy.
Beyond OUD-specific codes, the provider bills substantial psychotherapy and E/M service volumes under Medicaid (for example 90837 at $1.3M and 90832 at $319.5K), which indicates that while the core business is methadone-based OTP services, the organization also delivers a sizable behavioral health therapy caseload and routine office-based encounters. Several of these psychotherapy and E/M codes rank very high in-state (90837 at 97th percentile, 90832 at 98th percentile), reinforcing that counseling and psychotherapy are material components of its service mix.
The provider has an established operational history, with its NPI enumerated 2006-10-17 (~20 years ago), consistent with a stable, longstanding clinic model. Longevity combined with the high in-state ranks on key Medicaid codes (including multiple #1 and top-2 placements) supports the view that this entity is an entrenched regional provider of OUD and associated behavioral health services rather than a new entrant or transient operator.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 640 | $150 | $95.5K |
| 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 | 1,220 | $30 | $40.4K |
| 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… | 150 | $150 | $22.3K |
| 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… | 120 | $110 | $12.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
35 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 2,208,760 | $10 | $15.5M |
| 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… | 22,000 | $60 | $1.3M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 30,730 | $30 | $1M |
| H0038 | Self‑help/peer services, per 15 minutes | 24,310 | $40 | $851K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 8,580 | $70 | $618K |
| 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… | 14,100 | $30 | $465.4K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 61,240 | $10 | $428.6K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 3,930 | $110 | $416.8K |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 78,250 | $10 | $391.2K |
| 90832 | 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… | 15,220 | $20 | $319.5K |
Showing 1–10 of 35
How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Delaware median
35 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 2 | 10 | 77,020 | $10 | $3.4M |
| 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… | 2 | 20 | 1,500 | $90 | $361K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 2 | 10 | 860 | $40 | $316.4K |
| H0038 | Self‑help/peer services, per 15 minutes | 1 | 20 | 2,780 | $50 | $261.8K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 69 | 500 | 1,130 | $50 | $235.1K |
| 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… | 7 | 240 | 700 | $60 | $205.6K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 82 | 540 | 1,100 | $40 | $185.3K |
| 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… | 18 | 80 | 790 | $40 | $180.4K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 1 | 10 | 12,660 | $1 | $114.6K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 9 | 150 | 230 | $90 | $110.4K |
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Other providers in the same ZIP code as Brandywine Counseling & Community Services, Inc., ranked by combined Medicare and Medicaid revenue.
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