Agency
BHG XXXV, LLC
BHG XXXV, LLC was paid $14.37M by Medicaid between Jan 2018 and Dec 2024, across 27 billing codes. Its largest line is H0020, Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) — 84% of everything it billed.
33Billing provider infoBHG XXXV, LLC
LEXINGTON, KY 40511
LEXINGTON, KY 40511
33aNPI1386067254assigned 01/29/2014
33bProvider typeCase Management Agency
28Total paid$14.37M
24GClaims147,403
24DCodes billed27
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Case Management Agency providers in Kentucky
Rank by total paid#14 of 94
Median peer was paid$3.21M
This provider vs. median4.5×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 3,525 | $349K | |
| 2019 | 12,195 | $713K | |
| 2020 | 21,087 | $2.01M | |
| 2021 | 20,779 | $2.01M | |
| 2022 | 27,611 | $2.72M | |
| 2023 | 32,567 | $3.28M | |
| 2024incomplete | 29,639 | $3.30M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 84% | 127,137 | 29,645 | $12.01M |
| T2023 | Targeted case management; per month | 11% | 5,416 | 4,973 | $1.58M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 1.3% | 3,783 | 2,536 | $189K |
| T1007 | Alcohol and/or substance abuse services, treatment plan development and/or modification | <1% | 2,342 | 2,047 | $135K |
| H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | <1% | 666 | 620 | $120K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 1,921 | 1,382 | $81K |
| 99205 | Prolong outpt/office vis | <1% | 539 | 498 | $62K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 1,531 | 742 | $45K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,230 | 802 | $28K |
| 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 assessment, counseling; crisis intervention, and activity therapies or education | <1% | 331 | 46 | $25K |
| 90838 | <1% | 463 | 361 | $21K | |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 399 | 270 | $20K |
15 more codes
| H0033 | Oral medication administration, direct observation | <1% | 326 | $18K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 286 | $13K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 161 | $9K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 61 | $6K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 127 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 44 | $2K |
| H0001 | Alcohol and/or drug assessment | <1% | 27 | $1K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) | <1% | 325 | $1K |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 48 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 91 | $1K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 15 | $418.00 |
| 90836 | <1% | 17 | $332.22 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 12 | $302.49 |
| 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 | 0% | 14 | $0.00 |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 0% | 91 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialROMERO, TONYA (DIRECTOR OF PAYOR CREDENTIALING)
| Provider | Location | Paid |
|---|---|---|
| Vcphcs V, LLC | Gretna, LA | $12.95M |
| BHG XXXV, LLC | Berea, KY | $3.78M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.