#797 of 11K

90885

HCPCS Procedure Code

HCPCS code 90885 is the #797 most-billed Medicaid procedure code, with $78.2M in payments across 941K claims from 2018–2024. The national median cost per claim is $59.45. Costs vary widely — the 90th percentile is $148.84 per claim, 2.5× the median.

Total Paid

$78.2M

0.01% of all spending

Total Claims

941K

Providers

224

Avg Cost/Claim

$83

National Cost Distribution

How much do providers bill per claim for 90885? Based on 215 providers billing this code nationally.

Median

$59.45

Average

$75.14

Std Dev

$54.32

Max

$362.32

Percentile Distribution (Cost per Claim)

p10

$36.47

p25

$51.82

Median

$59.45

p75

$72.91

p90

$148.84

p95

$191.61

p99

$261.33

50% of providers bill between $51.82 and $72.91 per claim for this code.

90% bill between $36.47 and $148.84.

Top 1% bill above $261.33.

About This Procedure

HCPCS code 90885 was billed by 224 providers across 941K claims, totaling $78.2M in Medicaid payments from 2018–2024. This code was used for 395K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$59.45

Providers Billing

215

National Spending

$78.2M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90885

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Bhpn Llc Walnut Creek, CA · Case Management	$39.6M	$101.68	1.7× median	Above 75th
2	Easter Seals Southern California Inc Anaheim, CA · Behavior Analyst	$14.0M	$63.15	1.1× median	Above Median
3	1700105079	$5.4M	$58.57	1.0× median	Below Median
4	Easter Seals Southern California Inc Irvine, CA · Behavior Analyst	$5.3M	$88.77	1.5× median	Above 75th
5	County Of Sacramento Sacramento, CA · Clinic/Center Adult Mental Health	$1.7M	$232.40	3.9× median	Top 10%
6	County Of Santa Clara San Jose, CA · Community/Behavioral Health	$1.4M	$362.32	6.1× median	Top 1%
7	1609875186	$811K	$56.97	1.0× median	Below Median
8	City & County Of San Francisco San Francisco, CA · Community/Behavioral Health	$381K	$343.63	5.8× median	Top 1%
9	1609002005	$358K	$55.53	0.9× median	Below Median
10	1144404799	$272K	$75.45	1.3× median	Above 75th
11	1821087123	$251K	$72.95	1.2× median	Above 75th
12	1770535569	$248K	$64.11	1.1× median	Above Median
13	1457398547	$243K	$56.93	1.0× median	Below Median
14	1487047007	$227K	$141.23	2.4× median	Above 75th
15	1639180805	$204K	$54.20	0.9× median	Below Median
16	1366532103	$192K	$72.23	1.2× median	Above Median
17	1770719106	$183K	$95.02	1.6× median	Above 75th
18	1053364612	$179K	$52.87	0.9× median	Below Median
19	1386728681	$177K	$70.41	1.2× median	Above Median
20	1295132082	$167K	$49.77	0.8× median	Below Median

Showing top 20 of 224 providers billing this code

Related Procedures

90876$144.1M 90887Interpretation/explanation of results$144.0M 90882Environmental intervention$48.3M 90889$3.5M 90875$736K

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