96116
Neurobehavioral status examination, first hour
Neurobehavioral status examination, first hour is the #1,612 most-billed Medicaid procedure code, with $17.8M in payments across 216K claims from 2018–2024. The national median cost per claim is $46.64. Costs vary widely — the 90th percentile is $150.21 per claim, 3.2× the median.
Total Paid
$17.8M
0.00% of all spending
Total Claims
216K
Providers
535
Avg Cost/Claim
$82
National Cost Distribution
How much do providers bill per claim for 96116? Based on 483 providers billing this code nationally.
Median
$46.64
Average
$84.61
Std Dev
$197.96
Max
$2,756.25
Percentile Distribution (Cost per Claim)
50% of providers bill between $18.08 and $86.14 per claim for this code.
90% bill between $4.30 and $150.21.
Top 1% bill above $615.86.
About This Procedure
HCPCS code 96116 (Neurobehavioral status examination, first hour) was billed by 535 providers across 216K claims, totaling $17.8M in Medicaid payments from 2018–2024. This code was used for 150K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$46.64
Providers Billing
483
National Spending
$17.8M
Avg/Median Ratio
1.81×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 96116
| # | Provider | Total Paid |
|---|---|---|
| 1 | Bhpn Llc Walnut Creek, CA · Case Management | $3.8M |
| 2 | 1437780673 | $1.6M |
| 3 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $613K |
| 4 | 1619412046 | $538K |
| 5 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $390K |
| 6 | 1730137753 | $356K |
| 7 | Community Mental Health Authority Of Clinton Eaton Ingham Counties Lansing, MI · Clinic/Center Mental Health (Including Community Mental Health Center) | $353K |
| 8 | 1881087369 | $352K |
| 9 | 1841573375 | $293K |
| 10 | 1255396875 | $286K |
| 11 | 1295025997 | $264K |
| 12 | 1134639859 | $261K |
| 13 | Eastern Maine Medical Center Bangor, ME · General Acute Care Hospital | $244K |
| 14 | 1104364074 | $244K |
| 15 | 1316387699 | $235K |
| 16 | 1386295905 | $235K |
| 17 | Cook Children's Medical Center Fort Worth, TX · General Acute Care Hospital Children | $226K |
| 18 | 1053358846 | $200K |
| 19 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $187K |
| 20 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $179K |
Showing top 20 of 535 providers billing this code