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

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

Bgi Of Brandywine, LLC (NPI 1881756377)

Field	Value
Entity Type	Organization
Organization	Bgi Of Brandywine, LLC
Address	1375 Newark Rd
City	Kennett Square
State	PA
ZIP	19348
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	December 14, 2006

Payer Source	Total Paid
Medicaid	$54.5M
Medicare	$0

Key Findings

BGI OF BRANDYWINE, LLC is effectively a Medicaid-focused provider: there is no Medicare revenue on file while reported Medicaid revenue totals $54.5M, indicating the organization’s patient and payer mix is concentrated almost entirely in Medicaid-funded behavioral health and substance use services. The provider’s NPI was enumerated on 2006-12-14 (~20 years ago), which suggests an established operation with a long tenure in the market supporting Medicaid programs.

Revenue concentration is high and heavily skewed toward a few service lines: the top 3 Medicaid codes by revenue account for 79.4% of the provider’s total Medicaid revenue. The single largest code, H2036, represents $20.1M (36.9% of Medicaid revenue), followed by W7350 at $11.6M (21.3%) and H0018 at $11.5M (21.1%), indicating that a small set of per-diem residential and treatment program services drive the bulk of earnings.

The code mix and descriptions indicate core operations are residential and per-diem substance use treatment: H2036 (Alcohol and/or other drug treatment program, per diem) and H0018 (short-term residential behavioral health, per diem without room and board) together account for a substantial share of revenue, consistent with a facility-centered model providing daily residential treatment. H0013 (acute detoxification) and H0035 (partial hospitalization) also appear in the top codes, signaling that the provider offers a continuum from detox through inpatient-style residential and partial hospitalization services.

Competitive standing in-state is mixed by service line: for H2036 the provider ranks #9 of 117 (93th percentile), and for H0018 it ranks #8 of 95 (93th percentile), which places BGI as a sizable, typical-volume participant among Pennsylvania peers for those established residential codes. By contrast, W7350 and W7375 are reported with rank #1 of 1 and no peer-volume comparison, which means these codes cannot be contextualized against other in-state providers and may reflect unique billing descriptors or provider-specific internal codes.

Several top codes show typical peer-volume positioning rather than dominance: H2036, H0018, H0013, and H0035 all sit in percentiles characterized as typical or unremarkable (mostly in the 33rd–93rd percentile range), implying BGI competes as a substantial but not singular leader in common residential and detox services statewide. The provider’s leading placements (e.g., top ten ranks) indicate meaningful scale but not an outlier monopoly for standard treatment codes.

There are a few statistical or data anomalies worth noting for analysts: multiple codes (W7350, W7375, and RESRB) have no state peer comparisons or show rank #1 of 1, and RESRB reports $0 revenue despite claims being present. These entries suggest either vendor-specific code mappings, rate anomalies, or non-reimbursed claim lines that warrant operational or coding review when benchmarking against peers.

From a payer strategy perspective, the combination of high per-diem volumes (H2036, H0018) and material acute detoxification revenue (H0013 at $6.7M, 12.3% of Medicaid revenue) implies BGI’s services are oriented toward medium- to long-stay residential addiction treatment with clinical capacity for detox and step-down partial hospitalization. Payers evaluating network participation or utilization management should prioritize per-diem utilization and length-of-stay controls given the revenue concentration in daily-rate codes.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2036	Alcohol and/or other drug treatment program, per diem	67,760	$300	$20.1M
W7350	N/A	56,180	$210	$11.6M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	33,230	$350	$11.5M
H0013	Alcohol and/or drug services: acute detox (residential addiction program outpatient)	16,570	$400	$6.7M
W7375	N/A	8,500	$370	$3.2M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	3,850	$240	$927.9K
H2035	Alcohol and/or other drug treatment program, per hour	1,150	$200	$230.5K
H2016	Comprehensive community support services, per diem	430	$490	$209.8K
RESRB	N/A	120	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Bgi Of Brandywine, LLC — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W7350	N/A	1	10	56,180	$210	$11.7M
H2036	Alcohol and/or other drug treatment program, per diem	9	120	7,190	$420	$8.7M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	8	100	5,130	$370	$4.5M
W7375	N/A	1	10	8,500	$370	$3.2M
H0013	Alcohol and/or drug services: acute detox (residential addiction program outpatient)	5	60	2,400	$450	$2.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	75	110	8,460	$150	$2.1M
H2035	Alcohol and/or other drug treatment program, per hour	13	20	1,150	$180	$1.2M
H2016	Comprehensive community support services, per diem	3	10	890	$530	$412.2K
RESRB	N/A	1	10	120	$0	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Paul Alfieri	PA	Cardiovascular Disease Physician	$560.9K	$0
Longwood Fire Company	PA	Land Ambulance	$420.5K	$44.3K
Karl Zimmerman	PA	Internal Medicine Physician	$250.3K	$0
Nicole Pelick	PA	Occupational Therapist	$180.1K	$0
Pennsylvania Cvs Pharmacy, L.L.C.	PA	Pharmacy	$174.1K	$0
Marthe Adler	PA	Family Nurse Practitioner	$169.4K	$0
Eric Montgomery	PA	Anatomic Pathology & Clinical Pathology Physician	$122.4K	$0
Timothy Judson	PA	Clinical Social Worker	$95.1K	$0
Edward Jenny	PA	Clinical Psychologist	$32.6K	$0

Bgi Of Brandywine, LLC — Billing Profile & Reimbursement Data

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Bgi Of Brandywine, 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