Clinic
BHG XXV, LLC
BHG XXV, LLC was paid $6.28M by Medicaid between Jan 2018 and Nov 2024, across 17 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) — 67% of everything it billed.
33Billing provider infoBHG XXV, LLC
PIKEVILLE, KY 41501
PIKEVILLE, KY 41501
33aNPI1710323894assigned 05/16/2013
33bProvider typeMethadone Clinic
28Total paid$6.28M
24GClaims63,021
24DCodes billed17
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Methadone Clinic providers in Kentucky
Rank by total paid#6 of 16
Median peer was paid$4.29M
This provider vs. median1.5×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official HIGHAM, JAY controls 20+ related entities in our dataset. Read more
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 | 2,453 | $359K | |
| 2019 | 6,787 | $542K | |
| 2020 | 8,316 | $840K | |
| 2021 | 9,468 | $947K | |
| 2022 | 12,243 | $1.11M | |
| 2023 | 12,338 | $1.27M | |
| 2024incomplete | 11,416 | $1.22M |
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) | 67% | 43,759 | 9,920 | $4.18M |
| T2023 | Targeted case management; per month | 22% | 4,538 | 4,280 | $1.40M |
| T1007 | Alcohol and/or substance abuse services, treatment plan development and/or modification | 6.6% | 7,157 | 5,943 | $415K |
| 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 | 1.2% | 1,854 | 1,022 | $77K |
| 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% | 701 | 91 | $55K |
| 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% | 1,084 | 768 | $46K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 746 | 635 | $43K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 571 | 375 | $19K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 636 | 437 | $17K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 1,332 | 537 | $12K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 81 | 81 | $7K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 112 | 79 | $5K |
5 more codes
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 272 | $4K |
| 90838 | <1% | 89 | $2K | |
| H0001 | Alcohol and/or drug assessment | <1% | 58 | $2K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 18 | $583.00 |
| 99408 | <1% | 13 | $196.56 |
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 officialHIGHAM, JAY (CEO)
| Provider | Location | Paid |
|---|---|---|
| BHG Xlii, LLC | Virginia Beach, VA | $26.97M |
| Michigan Therapeutic Consultants PC | Mount Pleasant, MI | $23.78M |
| Valhalla Place, LLC | Woodbury, MN | $22.06M |
| Phoenix Health Center LLC | Hagerstown, MD | $21.41M |
| Valhalla Place, LLC | Brooklyn Park, MN | $19.08M |
| Alliance Clinic, LLC | Minneapolis, MN | $19.04M |
| DRD Management, INC | New Orleans, LA | $16.90M |
| BHG Xli, LLC | Chesapeake, VA | $16.62M |
| BHG Xxvi, LLC | Hazard, KY | $16.14M |
| BHG Reference Lab, LLC | Memphis, TN | $14.03M |
| Center for Behavioral Health Kentucky LLC | Louisville, KY | $13.15M |
| Center for Behavioral Health Indiana LLC | Fort Wayne, IN | $12.32M |
| Vcphcs Xii, LLC | Denver, CO | $11.54M |
| B Tek, LLC | Woodbury, MN | $10.26M |
| BHG Xlii, LLC | Glen Allen, VA | $10.15M |
| BHG Xlii, LLC | Newport News, VA | $9.32M |
| Valhalla Place Brainerd LLC | Brainerd, MN | $8.76M |
| DRD Management, INC | Knoxville, TN | $8.55M |
| BHG Xxiv, LLC | Paintsville, KY | $7.40M |
| Center for Behavioral Health Kentucky LLC | Richmond, KY | $7.19M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.