#1136 of 11K

0369T

HCPCS Procedure Code

HCPCS code 0369T is the #1,136 most-billed Medicaid procedure code, with $38.1M in payments across 310K claims from 2018–2024. The national median cost per claim is $102.36.

Total Paid

$38.1M

0.00% of all spending

Total Claims

310K

Providers

231

Avg Cost/Claim

$123

National Cost Distribution

How much do providers bill per claim for 0369T? Based on 230 providers billing this code nationally.

Median

$102.36

Average

$115.57

Std Dev

$71.87

Max

$541.20

Percentile Distribution (Cost per Claim)

p10

$40.08

p25

$72.28

Median

$102.36

p75

$142.32

p90

$199.19

p95

$232.91

p99

$344.15

50% of providers bill between $72.28 and $142.32 per claim for this code.

90% bill between $40.08 and $199.19.

Top 1% bill above $344.15.

About This Procedure

HCPCS code 0369T was billed by 231 providers across 310K claims, totaling $38.1M in Medicaid payments from 2018–2024. This code was used for 74K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$102.36

Providers Billing

230

National Spending

$38.1M

Avg/Median Ratio

1.13×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0369T

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Centria Healthcare Llc Farmington Hills, MI · Home Health	$9.0M	$188.08	1.8× median	Above 75th
2	Gateway Pediatric Therapy Llc Bingham Farms, MI · Behavior Analyst	$2.6M	$214.07	2.1× median	Top 10%
3	Eric Lund Green Bay, WI · Psychologist Clinical	$1.4M	$87.02	0.9× median	Below Median
4	1124198494	$929K	$278.11	2.7× median	Top 10%
5	1598007171	$869K	$119.50	1.2× median	Above Median
6	1609135748	$795K	$191.63	1.9× median	Above 75th
7	1821494584	$764K	$87.03	0.9× median	Below Median
8	Macomb Oakland Regional Center Inc. Auburn Hills, MI · Community/Behavioral Health	$609K	$214.46	2.1× median	Top 10%
9	1891917449	$590K	$177.92	1.7× median	Above 75th
10	1962765693	$525K	$136.05	1.3× median	Above Median
11	1518366285	$498K	$141.42	1.4× median	Above Median
12	1700897766	$491K	$123.54	1.2× median	Above Median
13	Community Mental Health For Central Michigan Mt Pleasant, MI · Psychiatry & Neurology Psychiatry	$464K	$541.20	5.3× median	Top 1%
14	1629322540	$414K	$202.93	2.0× median	Top 10%
15	1740670454	$411K	$139.46	1.4× median	Above Median
16	1770838468	$389K	$154.09	1.5× median	Above 75th
17	1376833061	$370K	$290.25	2.8× median	Top 10%
18	Residential Options Inc. Lansing, MI · Behavior Analyst	$366K	$85.48	0.8× median	Below Median
19	1063478287	$358K	$72.61	0.7× median	Below Median
20	1851478622	$336K	$153.67	1.5× median	Above 75th

Showing top 20 of 231 providers billing this code

Related Procedures

0365TAdaptive behavior treatment, each additional thirty minutes$168.7M 0364T$39.9M 0368T$19.5M 0373T$8.7M 0370T$5.3M

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