95800
HCPCS Procedure Code
HCPCS code 95800 is the #1,237 most-billed Medicaid procedure code, with $31.9M in payments across 163K claims from 2018–2024. The national median cost per claim is $86.65. Costs vary widely — the 90th percentile is $239.28 per claim, 2.8× the median.
Total Paid
$31.9M
0.00% of all spending
Total Claims
163K
Providers
450
Avg Cost/Claim
$196
National Cost Distribution
How much do providers bill per claim for 95800? Based on 438 providers billing this code nationally.
Median
$86.65
Average
$120.47
Std Dev
$141.43
Max
$1,244.37
Percentile Distribution (Cost per Claim)
50% of providers bill between $38.44 and $132.51 per claim for this code.
90% bill between $25.83 and $239.28.
Top 1% bill above $726.74.
About This Procedure
HCPCS code 95800 was billed by 450 providers across 163K claims, totaling $31.9M in Medicaid payments from 2018–2024. This code was used for 137K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$86.65
Providers Billing
438
National Spending
$31.9M
Avg/Median Ratio
1.39×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 95800
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1659839561 | $12.9M |
| 2 | Ahs Hospital Corp. Morristown, NJ · General Acute Care Hospital | $1.4M |
| 3 | Sage River Counseling Seattle, WA · Counselor Mental Health | $743K |
| 4 | Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization | $707K |
| 5 | 1477616571 | $640K |
| 6 | 1568780831 | $525K |
| 7 | 1013010917 | $488K |
| 8 | 1922262187 | $443K |
| 9 | 1457369381 | $438K |
| 10 | 1326224122 | $413K |
| 11 | Kaiser Foundation Health Plan Of The Northwest Portland, OR · General Practice | $402K |
| 12 | 1730667973 | $376K |
| 13 | 1841231461 | $342K |
| 14 | 1730721853 | $333K |
| 15 | 1548314495 | $265K |
| 16 | 1144253444 | $262K |
| 17 | 1457992604 | $256K |
| 18 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $237K |
| 19 | 1184097636 | $226K |
| 20 | 1295784445 | $222K |
Showing top 20 of 450 providers billing this code