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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Bright Start, LLC (NPI 1750698031)

Field	Value
Entity Type	Organization
Organization	Bright Start, LLC
Address	720 Gracern Rd
City	Columbia
State	SC
ZIP	29210
Taxonomy	Speech-Language Pathologist
NPI Enumerated	September 8, 2010

Payer Source	Total Paid
Medicaid	$20.8M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and $20.8M in Medicaid revenue, making it effectively a single‑payer (Medicaid-focused) operation in the available data. Its NPI was enumerated 2010-09-08 (~16 years ago), indicating a relatively long tenure to build concentrated Medicaid activity.

Revenue is highly concentrated: the top three Medicaid codes (T1017, T1027, T1016) together account for 95.2% of the provider's total Medicaid revenue. That concentration means most of the practice’s financial footprint is tied to a narrow set of case management and family training service lines.

The code mix (T1017 – targeted case management; T1027 – family training and counseling for child development; T1016 – case management) indicates the operation is primarily delivering case management and family/child development support rather than billing predominantly for one‑to‑one therapy. Activity volumes are large: T1017 shows 239.7K claims at $42 avg paid/claim, T1027 shows 52.4K claims at $95 avg paid/claim, and T1016 shows 91.7K claims at $52 avg paid/claim, underscoring a model built on frequent, short‑interval service units.

On competitive standing within the state this provider is a dominant outlier for its top codes: T1017 ranks #1 of 57 providers in‑state (100th percentile; extreme outlier), T1027 ranks #2 of 81 (99th percentile; extreme outlier), and T1016 ranks #3 of 102 (98th percentile; extreme outlier). These ranks reflect volumes far above typical state peers and position the provider as a major statewide actor in Medicaid case management and family training services.

The payment mix shows T1017 is a high‑volume, lower‑unit‑price driver ($42 avg), while T1027 is lower‑volume but higher unit price ($95 avg), and T1016 sits between them at $52 avg; this combination produces a revenue profile driven by both volume and intermediate unit rates. Reliance on large claim counts for T1017 and T1016 suggests the business model depends on frequent 15‑minute service units.

Direct therapy (92507) represents a much smaller share of revenue: 10.8K claims at $90 avg paid/claim produced $974.1K (4.7% of Medicaid revenue) and ranks in the 78th percentile statewide (typical volume). This indicates that one‑to‑one speech therapy is a secondary component of the provider’s Medicaid portfolio compared with case management and family training.

School/IEP bundled services (T1018) are negligible in the revenue mix, with 471 claims at $73 avg paid/claim yielding $34.4K (0.2% of Medicaid revenue) and a mid‑range rank in‑state (41st percentile; typical). The limited T1018 activity suggests the provider is not primarily operating as a school‑based IEP billing entity.

Because 95.2% of Medicaid revenue is concentrated in administrative and family support codes, the provider’s financial stability and growth prospects are closely tied to Medicaid authorization rules and reimbursement policies for case management and family training. Any policy or coverage change affecting T1017, T1027, or T1016 would likely have an outsized impact on the business compared with shifts in direct therapy or school‑based billing.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	239,720	$40	$10.1M
T1027	Family training and counseling for child development, per 15 minutes	52,430	$100	$5M
T1016	Case management, each 15 minutes	91,670	$50	$4.8M
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…	10,820	$90	$974.1K
T1018	School-based individualized education program (iep) services, bundled	470	$70	$34.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Bright Start, LLC — 3 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	1	60	7,610	$50	$1.2M
T1027	Family training and counseling for child development, per 15 minutes	2	80	3,560	$100	$857.8K
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…	77	340	2,970	$80	$711.1K
T1016	Case management, each 15 minutes	3	100	4,210	$50	$614.8K
T1018	School-based individualized education program (iep) services, bundled	17	30	650	$90	$111.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Youth Advocate Program	SC	Community/Behavioral Health Agency	$0	$64M
Lifehme, Inc.	SC	Oxygen Equipment & Supplies (DME)	$0	$45.6M
Pal-med, LLC	SC	Durable Medical Equipment & Medical Supplies	$0	$26.2M
Kids First Dental, LLC	SC	Dentist	$0	$20.6M
Hospice Care Of South Carolina, Lowcountry, LLC	SC	Community Based Hospice Care Agency	$0	$19.9M
Crescent Hospice, Inc.	SC	Community Based Hospice Care Agency	$0	$17.3M
Coram Healthcare/carolina Home Therapeutics	SC	Home Infusion Therapy Pharmacy	$0	$13.9M
Caring Healthcare, Inc.	SC	Nursing Care Agency	$0	$13.3M
Richland/lexington Disabilities And Special Needs Board	SC	Case Management Agency	$0	$11.3M
Compassionate Care Hospice Of South Carolina, LLC	SC	Community Based Hospice Care Agency	$0	$9.6M

Bright Start, LLC — Billing Profile & Reimbursement Data

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Bright Start, 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