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NPI 1932633518 · Washington, DC · Substance Use Disorder Rehabilitation Clinic/Center
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Bhg Xlvi, LLC is a substance use disorder rehabilitation clinic/center provider located in Washington, District of Columbia. This profile covers 4 Medicare and 21 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 | Bhg Xlvi, LLC |
| Address | 1320 Marion Barry Ave Se |
| City | Washington |
| State | DC |
| ZIP | 20020 |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| NPI Enumerated | April 20, 2017 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3.9M |
| Medicare | $749.3K |
BHG XLVI, LLC operates as a substance use disorder opioid treatment program focused on methadone-based medication-assisted treatment: its Medicare top code is G2067 (Medication assisted treatment, methadone weekly bundle) and its largest Medicaid code is H0020 (methadone administration/service). The presence of counseling/therapy codes (H0004, 90832, 90837), screening (H0002), and frequent toxicology collection/testing codes (H0048, 80305) indicates the organization delivers both medication dispensing and ancillary behavioral health and lab services typical of an OTP.
Medicare revenue is highly concentrated: the provider reports Total Medicare revenue of $749.3K and its top 3 Medicare codes account for 98.8% of that Medicare revenue. G2067 alone drives $713.4K (95.1% of Medicare revenue), signaling that virtually all Medicare receipts come from the weekly methadone treatment bundle rather than diversified Medicare services.
Medicaid revenue is even larger in absolute terms but similarly concentrated: Total Medicaid revenue is $3.9M with the top 3 Medicaid codes representing 93.2% of Medicaid revenue. H0020 (methadone administration/service) accounts for $3.2M (84.0% of Medicaid revenue) and H0004 (behavioral health counseling, per 15 minutes) contributes $261.2K (6.9%), showing that Medicaid receipts are dominated by methadone dispensing plus a secondary counseling component.
The provider’s payer mix is effectively Medicaid-dominant: lifetime Medicaid revenue ($3.9M) materially exceeds lifetime Medicare revenue ($749.3K), indicating the practice’s scale and patient population are driven mainly by Medicaid-covered clients rather than Medicare beneficiaries. This profile is consistent with OTPs that serve a predominantly younger or disabled population enrolled in Medicaid programs.
Competitive standing varies by payer and code: for Medicare G2067 the provider ranks #51 of 830 nationally (94th percentile), placing it among higher-volume national peers for that OTP bundle, though the supplied label describes that volume as "typical, unremarkable." In-state for Medicaid, H0020 ranks #3 of 5 (50th percentile), which points to a middle-tier position among local OTPs on methadone administration volume while H0004 ranks #24 of 82 (72nd percentile), indicating stronger relative placement for counseling services in-state.
There are multiple Medicaid-listed OTP codes with high claim counts but reported $0 average paid and $0 revenue (for example, G2067: 7.2K claims, $0 avg paid/claim, $0 revenue; G2078: 796 claims, $0 avg paid/claim, $0 revenue; G2077: 230 claims, $0 avg paid/claim, $0 revenue). These zero-dollar payment lines suggest state-specific billing or reporting patterns (claims filed without Medicaid payments recorded) rather than additional earned revenue, and they should be investigated further if payment capture or contract anomalies are of interest.
The service mix beyond dispensing shows active provision of structured psychosocial care and monitoring: sizable Medicaid volumes for H0004 (6.5K claims, $261.2K) and H0048 (7.6K claims, $60.6K) plus screening and skills-training codes (H0002, H2014) indicate the clinic bundles counseling, screening, and frequent toxicology collection alongside medication dispensing. That combination aligns with a comprehensive OTP model where counseling and frequent testing are core elements of reimbursable workflows.
The provider’s tenure (NPI enumerated 2017-04-20, ~9 years ago) and lifetime revenue totals ($749.3K Medicare; $3.9M Medicaid) point to a small-to-midsize, established OTP operation in Washington, DC. Given the extreme revenue concentration in methadone administration codes on both payers (top-3 shares of 98.8% Medicare and 93.2% Medicaid), the organization’s business risk and competitive positioning will be highly sensitive to policy, payment, or contract changes that affect OTP bundles and methadone service reimbursement.
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… | 2,680 | $270 | $713.4K |
| 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 | 410 | $40 | $16K |
| 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… | 90 | $130 | $11.5K |
| 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… | 40 | $220 | $9.2K |
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.
21 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) | 351,390 | $10 | $3.2M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 6,530 | $40 | $261.2K |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | 530 | $170 | $88.7K |
| H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | 1,140 | $60 | $65.9K |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 7,580 | $10 | $60.6K |
| H0001 | Alcohol and/or drug assessment | 160 | $220 | $35.8K |
| H2014 | Skills training and development, per 15 minutes | 1,020 | $20 | $22.4K |
| 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… | 570 | $40 | $21.1K |
| 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… | 120 | $110 | $13.3K |
| H2027 | Psychoeducational service, per 15 minutes | 680 | $20 | $11.6K |
Showing 1–10 of 21
How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. District of Columbia median
21 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) | 3 | 10 | 351,390 | $10 | $3.7M |
| 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… | 98 | 120 | 1,050 | $110 | $409.5K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 24 | 80 | 2,570 | $60 | $403K |
| 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… | 259 | 310 | 750 | $70 | $321.6K |
| 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… | 296 | 320 | 620 | $50 | $313.6K |
| H2014 | Skills training and development, per 15 minutes | 16 | 30 | 1,560 | $40 | $198.5K |
| H2027 | Psychoeducational service, per 15 minutes | 16 | 30 | 1,320 | $20 | $133.9K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | 21 | 20 | 1,540 | $30 | $125.6K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 53 | 80 | 370 | $130 | $124.7K |
| H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | 4 | 10 | 740 | $70 | $107K |
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Other providers in the same ZIP code as Bhg Xlvi, LLC, ranked by combined Medicare and Medicaid revenue.
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