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

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

Bhpn, LLC (NPI 1588157424)

Field	Value
Entity Type	Organization
Organization	Bhpn, LLC
Address	2730 Shadelands Dr Ste 200
City	Walnut Creek
State	CA
ZIP	94598
Taxonomy	Case Management Agency
NPI Enumerated	June 14, 2018

Payer Source	Total Paid
Medicaid	$350.7M
Medicare	$0

Key Findings

BHPN, LLC is effectively a Medicaid-focused operation with Total Medicaid revenue of $350.7M and no Medicare billing on file. The absence of any Medicare claims means payer analysis should treat this entity as single-payer (Medicaid) in scale and exposure rather than a mixed Medicare/Medicaid profile.

Revenue is highly concentrated: the top three Medicaid codes (H2019, H0032, 90885) together account for 83.1% of this provider’s Medicaid revenue. Those three codes individually represent $179M (51.0%), $72.9M (20.8%), and $39.7M (11.3%) of the $350.7M total, respectively, indicating a narrow set of services drives the vast majority of revenue.

The code mix points to a high-volume behavioral health and care-planning operation consistent with the Case Management Agency taxonomy: H2019 (Therapeutic behavioral services, per 15 minutes) and H0032 (Mental health service plan development by non-physician) are the largest contributors, and 90885 (record review supporting psychiatric evaluation) is also a major revenue source. This combination implies operations built around minute-based therapeutic contacts, structured non-physician care planning, and substantial clinical record-review work rather than traditional physician-delivered procedures.

BHPN is a dominant statewide player on multiple key Medicaid codes: H2019 ranks #1 of 657 providers in-state (100th percentile; extreme outlier), H0032 ranks #2 of 976 (100th percentile; extreme outlier), and 90885 ranks #1 of 34 (100th percentile; extreme outlier). Those rank/percentile labels indicate the provider operates at a scale far above typical state volume for these services and is a market outlier in behavioral health delivery.

Operational scale is reflected in extremely large claim counts for the top codes: H2019 shows 1.2M claims, H0032 shows 473.4K claims, and 90885 shows 389.1K claims. These volumes suggest many short-duration service units (consistent with per-15-minute billing) and a substantial administrative/clinical workload associated with plan development and record review.

Beyond the top three, the provider also bills meaningful volumes of related services: H0004 accounts for $32.3M (9.2%, rank #9 of 204; 96th percentile, notably above typical), H2014 accounts for $10M (2.9%, rank #1 of 144; 100th percentile, extreme outlier), and 96116 accounts for $3.8M (1.1%, rank #8 of 70; 90th percentile, typical). This pattern shows some breadth in behavioral health counseling, skills training, and face-to-face assessment activities, but these lines remain secondary to the top three revenue drivers.

The provider’s NPI was enumerated 2018-06-14 (~8 years ago), and in that relatively short tenure it has scaled to become an extreme outlier on multiple in-state codes. For analysts this rapid rise to dominant statewide volume in specific Medicaid codes is a notable business-profile signal and highlights where payer oversight or competitive benchmarking should focus.

High concentration in a few minute-based behavioral health and planning codes (top 3 = 83.1% of Medicaid revenue) creates revenue dependence on a narrow set of services and reimbursement policies. Given the provider’s outlier ranks on multiple high-revenue codes, changes to coverage, unit definitions, or audit focus for H2019, H0032, or 90885 would likely have disproportionate financial impact on this entity.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2019	Therapeutic behavioral services, per 15 minutes	1,154,910	$160	$179M
H0032	Mental health service plan development by non-physician	473,390	$150	$72.9M
90885	The provider reviews the medical records of the patient pertaining to psychiatric evaluation to help in establishing the diagnosis and treatment plan.	389,080	$100	$39.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	254,600	$130	$32.3M
H0031	Mental health assessment, by non-physician	6,130	$1,690	$10.4M
H2014	Skills training and development, per 15 minutes	68,180	$150	$10M
96116	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for the first hour of face–to–face…	1,500	$2,510	$3.8M
H2000	Comprehensive multidisciplinary evaluation	6,360	$200	$1.3M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	39,620	$20	$911.2K
S5110	Home care training, family; per 15 minutes	5,820	$50	$279.5K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Bhpn, LLC — 7 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	9	200	3,070	$120	$4.5M
H2019	Therapeutic behavioral services, per 15 minutes	1	660	4,750	$140	$3.1M
90885	The provider reviews the medical records of the patient pertaining to psychiatric evaluation to help in establishing the diagnosis and treatment plan.	1	30	380	$90	$2M
H0032	Mental health service plan development by non-physician	2	980	1,080	$160	$1.5M
H0031	Mental health assessment, by non-physician	42	360	330	$180	$492.6K
H2014	Skills training and development, per 15 minutes	1	140	790	$120	$395.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	39	960	1,820	$50	$351.9K
S5110	Home care training, family; per 15 minutes	23	240	400	$80	$152.1K
96116	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for the first hour of face–to–face…	8	70	90	$110	$64K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	45	520	380	$40	$62.8K

Showing 1–10 of 12

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Easterseals Northern California	CA	Behavior Analyst	$0	$50.1M
John Muir Health	CA	General Acute Care Hospital	$0	$32.4M
Bay Area Retina Associates	CA	Retina Specialist (Ophthalmology) Physician	$0	$30.4M
Aspen Surgery Center, LLC	CA	Ambulatory Surgical Clinic/Center	$5.7M	$2M
Sequoia Surgical Center LP	CA	Ambulatory Surgical Clinic/Center	$2.6M	$3.8M
Min-wei Lee	CA	Dermatology Physician	$390.1K	$5.1M
Roger Goldberg	CA	Retina Specialist (Ophthalmology) Physician	$4.6M	$0
Michael Sherman	CA	Hematology & Oncology Physician	$3.9M	$0
Rajiv Nagesetty	CA	Vascular Surgery Physician	$3.6M	$0
Patrick Gonzales	CA	Vascular & Interventional Radiology Physician	$2.7M	$0

Bhpn, LLC — Billing Profile & Reimbursement Data

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Bhpn, 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