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NPI 1659769446 · Cincinnati, OH · Addiction Medicine (Internal Medicine) Physician
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Brightview, LLC is a addiction medicine (internal medicine) physician provider located in Cincinnati, Ohio. This profile covers 11 Medicare and 85 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 | Brightview, LLC |
| Address | 446 Morgan St |
| City | Cincinnati |
| State | OH |
| ZIP | 45206 |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| NPI Enumerated | December 31, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $501.1M |
| Medicare | $2.3M |
BRIGHTVIEW, LLC reports total Medicare revenue of $2.3M and total Medicaid revenue of $501.1M, indicating Medicaid is the overwhelmingly dominant payer for this entity; in practical terms the provider operates as a Medicaid-centric operation with only a small Medicare footprint. This payer mix implies that contracting, utilization, and policy changes on the Medicaid side will have outsized impact on the organization compared with Medicare.
The top Medicare codes are concentrated in opioid treatment program services—G2068, G2077 and G2079—which together account for 62.1% of the provider's Medicare revenue. Specific Medicare activity is heavy in bundled medication-assisted treatment and related periodic assessment and take-home buprenorphine services (e.g., G2068 reported 3K claims and $815.7K revenue), indicating the provider bills Medicare primarily for OTP-style MAT services rather than broad inpatient or specialty procedures.
Medicaid billing is dominated by large-scale medication dispensing and administration plus associated testing and behavioral health codes, with S5000, T1502 and 99214 among the top drivers that collectively account for 57.4% of Medicaid revenue. The state-level volumes are massive for these lines (for example S5000: 486.2K claims, $105M revenue; T1502: 536.2K claims, $94.9M revenue; 99214: 713.9K claims, $72.1M revenue), which points to a high-throughput, medication-centric ambulatory model integrated with routine E/M visits.
On Medicare measures BRIGHTVIEW is a national outlier for several OTP codes: G2068 ranks #1 of 13 providers nationally (100th percentile; extreme outlier) and G2077 ranks #1 of 352 providers nationally (100th percentile; extreme outlier). Those rankings indicate the provider bills far above typical national Medicare volume for OTP-related services even though absolute Medicare revenue is modest compared with its Medicaid book.
The provider’s Medicaid competitive standing is dominant in-state across multiple lines of business: S5000, T1502, 80307, G0483 and G0482 all rank #1 in Ohio (100th percentile; extreme outlier for many), and several behavioral health and testing codes (H0014, H0005, 80346, 80361) are likewise at or near the top of state rankings. This pattern shows BRIGHTVIEW is a major statewide player for prescription dispensing, medication administration, drug testing and ambulatory substance use services, making it a key counterparty for Medicaid payers and state program administrators.
The code mix shows an integrated service model: high-volume dispensing and administration codes are paired with extensive toxicology testing (80307, G0483/G0482) and psychotherapy/group counseling codes (90837, 90834, 90832), suggesting BRIGHTVIEW operates both pharmacy/distribution and clinical counseling workflows in support of addiction treatment. Combined high volumes in 99214 and time-based psychotherapy codes imply sustained patient contact and recurring visits rather than one-off encounters.
Revenue concentration creates operational and payer risk because a majority of revenue for each payer is tied to a small set of services (top 3 Medicare codes = 62.1% of Medicare revenue; top 3 Medicaid codes = 57.4% of Medicaid revenue). Any changes to reimbursement, prior authorization, or state program rules for OTP bundles, dispensings (S5000), or mass testing could materially affect revenues, so payers should evaluate utilization trends and claim-level patterns when managing financial exposure.
BRIGHTVIEW’s NPI was enumerated on 2014-12-31 (~12 years ago), indicating an established presence in the market; combined with its top-percentile state rankings and extreme-volume Medicaid billing, the organization is likely a mature, high-capacity provider within Ohio’s behavioral health and substance use treatment ecosystem. For payers and network planners, BRIGHTVIEW represents a concentrated source of Medicaid addiction-treatment volume that will be important for capacity planning and network adequacy assessments.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G2068 | Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if… | 3,010 | $270 | $815.7K |
| 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… | 3,150 | $110 | $336.6K |
| G2079 | Take-home supply of buprenorphine (oral); 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… | 3,560 | $80 | $281.1K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1,100 | $240 | $263.5K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1,050 | $200 | $204.4K |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 3,340 | $60 | $203.9K |
| 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… | 380 | $180 | $67.1K |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 440 | $150 | $66.7K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 230 | $230 | $52.7K |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 110 | $110 | $12.5K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
11 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G2068 | 1 | 10 | 470 | $270 | $232.3K |
| G2079 | 1 | 10 | 660 | $80 | $117.4K |
| G2067 | 20 | 20 | 360 | $230 | $96.4K |
| G2074 | 1 | 10 | 220 | $180 | $45K |
| G2077 | 1 | 10 | 60 | $110 | $43.2K |
| G0483 | 1 | 20 | 90 | $240 | $42.5K |
| G0482 | 2 | 40 | 100 | $190 | $40.6K |
| G0480 | 12 | 30 | 110 | $110 | $38.8K |
| G0481 | 4 | 30 | 120 | $150 | $30.5K |
| 80307 | 2 | 100 | 150 | $60 | $18.8K |
Showing 1–10 of 11
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
85 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| S5000 | Prescription drug, generic | 486,180 | $220 | $105M |
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | 536,200 | $180 | $94.9M |
| 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… | 713,950 | $100 | $72.1M |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 861,320 | $50 | $38.8M |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 225,130 | $130 | $30.2M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 243,890 | $110 | $27.8M |
| H0014 | Alcohol and/or drug services; ambulatory detoxification | 107,360 | $250 | $26.7M |
| 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… | 126,420 | $90 | $11.8M |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 140,590 | $70 | $9.6M |
| 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… | 128,310 | $70 | $8.5M |
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How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
85 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| S5000 | Prescription drug, generic | 1 | 20 | 2,720 | $150 | $7.7M |
| T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | 1 | 40 | 2,350 | $140 | $4.4M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 17 | 120 | 7,190 | $30 | $2.6M |
| 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… | 198 | 610 | 1,350 | $150 | $1.9M |
| T2023 | Targeted case management; per month | 1 | 20 | 1,050 | $380 | $1.2M |
| H0014 | Alcohol and/or drug services; ambulatory detoxification | 1 | 40 | 780 | $260 | $1.1M |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1 | 80 | 910 | $110 | $884.9K |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 1 | 50 | 310 | $110 | $817.2K |
| T1007 | Alcohol and/or substance abuse services, treatment plan development and/or modification | 1 | 10 | 80 | $50 | $562.5K |
| H0012 | Behavioral health day treatment, per hour | 24 | 30 | 650 | $340 | $476.3K |
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Other providers in the same ZIP code as Brightview, LLC, ranked by combined Medicare and Medicaid revenue.
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