#876 of 11K

96150

Health behavior assessment, initial

Health behavior assessment, initial is the #876 most-billed Medicaid procedure code, with $64.1M in payments across 519K claims from 2018–2024. The national median cost per claim is $17.83. Costs vary widely — the 90th percentile is $53.42 per claim, 3.0× the median.

Total Paid

$64.1M

0.01% of all spending

Total Claims

519K

Providers

Avg Cost/Claim

$124

National Cost Distribution

How much do providers bill per claim for 96150? Based on 803 providers billing this code nationally.

Median

$17.83

Average

$27.88

Std Dev

$56.67

Max

$1,082.72

Percentile Distribution (Cost per Claim)

p10

$0.64

p25

$6.03

Median

$17.83

p75

$25.36

p90

$53.42

p95

$96.81

p99

$227.85

50% of providers bill between $6.03 and $25.36 per claim for this code.

90% bill between $0.64 and $53.42.

Top 1% bill above $227.85.

About This Procedure

HCPCS code 96150 (Health behavior assessment, initial) was billed by 1K providers across 519K claims, totaling $64.1M in Medicaid payments from 2018–2024. This code was used for 356K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.83

Providers Billing

803

National Spending

$64.1M

Avg/Median Ratio

1.56×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 96150

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Baker Hall Inc Lackawanna, NY · Psychiatric Residential Treatment Facility	$47.3M	$1,082.72	60.7× median	Top 1%
2	Villa Of Hope Rochester, NY · Voluntary or Charitable	$8.6M	$539.07	30.2× median	Top 1%
3	1558431981	$822K	$43.32	2.4× median	Above 75th
4	1114138286	$726K	$53.00	3.0× median	Above 75th
5	1447313168	$391K	$33.27	1.9× median	Above 75th
6	1891821989	$212K	$22.77	1.3× median	Above Median
7	1962605048	$173K	$25.63	1.4× median	Above 75th
8	1376607648	$162K	$24.38	1.4× median	Above Median
9	1063575785	$139K	$33.44	1.9× median	Above 75th
10	1366574048	$135K	$22.15	1.2× median	Above Median
11	1003902610	$134K	$23.08	1.3× median	Above Median
12	1114088010	$127K	$28.62	1.6× median	Above 75th
13	1174820815	$116K	$53.53	3.0× median	Top 10%
14	1881941433	$91K	$22.17	1.2× median	Above Median
15	1467508937	$89K	$21.06	1.2× median	Above Median
16	1861557704	$86K	$24.39	1.4× median	Above Median
17	1316019201	$81K	$19.48	1.1× median	Above Median
18	1720260417	$78K	$51.43	2.9× median	Above 75th
19	1912062316	$77K	$20.90	1.2× median	Above Median
20	1619041753	$76K	$18.63	1.0× median	Above Median

Showing top 20 of 1K providers billing this code

Related Procedures

96152Health behavior intervention, individual$165.4M 96159$116.2M 96158$107.5M 96156$99.9M 96153Health/behavior intervention, group$94.3M

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