#863 of 11K

0101

HCPCS Procedure Code

HCPCS code 0101 is the #863 most-billed Medicaid procedure code, with $66.0M in payments across 13K claims from 2018–2024. The national median cost per claim is $3,098.15. Costs vary widely — the 90th percentile is $9,809.20 per claim, 3.2× the median.

Total Paid

$66.0M

0.01% of all spending

Total Claims

13K

Providers

Avg Cost/Claim

$5K

National Cost Distribution

How much do providers bill per claim for 0101? Based on 30 providers billing this code nationally.

Median

$3,098.15

Average

$4,150.41

Std Dev

$4,109.45

Max

$19,491.97

Percentile Distribution (Cost per Claim)

p10

$785.58

p25

$1,245.72

Median

$3,098.15

p75

$5,411.85

p90

$9,809.20

p95

$10,574.50

p99

$16,953.94

50% of providers bill between $1,245.72 and $5,411.85 per claim for this code.

90% bill between $785.58 and $9,809.20.

Top 1% bill above $16,953.94.

About This Procedure

HCPCS code 0101 was billed by 31 providers across 13K claims, totaling $66.0M in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3,098.15

Providers Billing

National Spending

$66.0M

Avg/Median Ratio

1.34×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0101

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Alameda Health System San Leandro, CA · Assisted Living Facility	$30.6M	$19,491.97	6.3× median	Top 1%
2	1710066634	$8.2M	$5,532.75	1.8× median	Above 75th
3	Developmental Client Care Moreno Valley, CA · Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$5.9M	$5,417.92	1.7× median	Above 75th
4	1467653303	$2.7M	$9,746.66	3.1× median	Above 75th
5	1316021942	$2.6M	$5,221.43	1.7× median	Above Median
6	1437241692	$2.5M	$1,700.67	0.5× median	Below Median
7	Del Dios Care Llc Escondido, CA · Assisted Living Facility	$1.4M	$923.08	0.3× median	Below Median
8	1114124849	$1.4M	$1,994.93	0.6× median	Below Median
9	1982862132	$1.4M	$2,245.90	0.7× median	Below Median
10	1598221863	$1.0M	$2,794.22	0.9× median	Below Median
11	1588730881	$976K	$3,484.44	1.1× median	Above Median
12	1457428427	$957K	$2,112.91	0.7× median	Below Median
13	1518119775	$923K	$10,372.04	3.3× median	Top 10%
14	Del Rio Care Llc San Diego, CA · Assisted Living Facility	$920K	$919.25	0.3× median	Below Median
15	1720254535	$655K	$6,061.15	2.0× median	Above 75th
16	1760658157	$607K	$5,469.64	1.8× median	Above 75th
17	1124063763	$601K	$2,960.51	1.0× median	Below Median
18	Ablelight Inc. Watertown, WI · Intermediate Care Facility, Intellectual Disabilities	$478K	$1,516.96	0.5× median	Below Median
19	1699840231	$425K	$4,291.19	1.4× median	Above Median
20	1861579468	$417K	$5,344.14	1.7× median	Above Median

Showing top 20 of 31 providers billing this code

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