96113
Developmental test admin, each additional 30 min
Developmental test admin, each additional 30 min is the #1,544 most-billed Medicaid procedure code, with $19.7M in payments across 159K claims from 2018–2024. The national median cost per claim is $77.06. Costs vary widely — the 90th percentile is $262.46 per claim, 3.4× the median.
Total Paid
$19.7M
0.00% of all spending
Total Claims
159K
Providers
391
Avg Cost/Claim
$124
National Cost Distribution
How much do providers bill per claim for 96113? Based on 379 providers billing this code nationally.
Median
$77.06
Average
$125.69
Std Dev
$147.79
Max
$1,312.39
Percentile Distribution (Cost per Claim)
50% of providers bill between $48.36 and $140.78 per claim for this code.
90% bill between $30.76 and $262.46.
Top 1% bill above $719.00.
About This Procedure
HCPCS code 96113 (Developmental test admin, each additional 30 min) was billed by 391 providers across 159K claims, totaling $19.7M in Medicaid payments from 2018–2024. This code was used for 128K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$77.06
Providers Billing
379
National Spending
$19.7M
Avg/Median Ratio
1.63×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 96113
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1568807659 | $1.9M |
| 2 | 1720381395 | $986K |
| 3 | 1700110285 | $573K |
| 4 | 1881079770 | $557K |
| 5 | 1164735551 | $554K |
| 6 | 1619487287 | $521K |
| 7 | 1396814331 | $458K |
| 8 | 1033449145 | $448K |
| 9 | 1154465557 | $410K |
| 10 | Kid Success Inc. Conway, AR · Clinic/Center Rehabilitation | $385K |
| 11 | 1275921587 | $379K |
| 12 | 1104041540 | $350K |
| 13 | 1487047007 | $338K |
| 14 | 1063637411 | $336K |
| 15 | 1760507990 | $324K |
| 16 | 1598865883 | $304K |
| 17 | 1912082645 | $283K |
| 18 | 1942424387 | $273K |
| 19 | Collaborative Autism Management Programs Inc. Ontario, CA · Behavior Analyst | $266K |
| 20 | 1255979340 | $264K |
Showing top 20 of 391 providers billing this code