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#487 of 11K

96127

Brief emotional/behavioral assessment, per standardized instrument

Brief emotional/behavioral assessment, per standardized instrument is the #487 most-billed Medicaid procedure code, with $191.1M in payments across 29.8M claims from 2018–2024. The national median cost per claim is $3.67. Costs vary widely — the 90th percentile is $14.35 per claim, 3.9× the median.

Total Paid

$191.1M

0.02% of all spending

Total Claims

29.8M

Providers

19K

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for 96127? Based on 16K providers billing this code nationally.

Median

$3.67

Average

$6.65

Std Dev

$19.75

Max

$1,279.16

Percentile Distribution (Cost per Claim)

p10
$0.38
p25
$1.96
Median
$3.67
p75
$5.87
p90
$14.35
p95
$17.30
p99
$57.89

50% of providers bill between $1.96 and $5.87 per claim for this code.

90% bill between $0.38 and $14.35.

Top 1% bill above $57.89.

About This Procedure

HCPCS code 96127 (Brief emotional/behavioral assessment, per standardized instrument) was billed by 19K providers across 29.8M claims, totaling $191.1M in Medicaid payments from 2018–2024. This code was used for 25.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.67

Providers Billing

16K

National Spending

$191.1M

Avg/Median Ratio

1.81×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 96127

#ProviderTotal Paid
1Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$21.1M
2Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$11.0M
3The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$5.5M
41518042175$3.7M
5Montefiore Medical Center

Bronx, NY · Anesthesiology

$3.3M
6The Toledo Hospital

Toledo, OH · Pediatrics

$1.9M
7Hennepin Healthcare System Inc

Minneapolis, MN · General Acute Care Hospital

$1.9M
81174520084$1.4M
91477554814$1.3M
101407243223$1.2M
111720194053$1.2M
121245833565$1.1M
131689669293$1.1M
141801826680$968K
151912281940$963K
16Mary Imogene Bassett Hospital

Cooperstown, NY · General Acute Care Hospital, Rural

$935K
171790839405$814K
18Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$718K
191063586071$710K
20Los Angeles County Department Of Mental Health

Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$701K

Showing top 20 of 19K providers billing this code