96153
Health/behavior intervention, group
Health/behavior intervention, group is the #730 most-billed Medicaid procedure code, with $94.3M in payments across 3.6M claims from 2018–2024. The national median cost per claim is $6.67. Costs vary widely — the 90th percentile is $58.86 per claim, 8.8× the median.
Total Paid
$94.3M
0.01% of all spending
Total Claims
3.6M
Providers
929
Avg Cost/Claim
$26
National Cost Distribution
How much do providers bill per claim for 96153? Based on 853 providers billing this code nationally.
Median
$6.67
Average
$18.52
Std Dev
$41.61
Max
$670.25
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.52 and $10.19 per claim for this code.
90% bill between $1.92 and $58.86.
Top 1% bill above $125.13.
About This Procedure
HCPCS code 96153 (Health/behavior intervention, group) was billed by 929 providers across 3.6M claims, totaling $94.3M in Medicaid payments from 2018–2024. This code was used for 887K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$6.67
Providers Billing
853
National Spending
$94.3M
Avg/Median Ratio
2.78×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 96153
| # | Provider | Total Paid |
|---|---|---|
| 1 | Council Bluffs Community School District Council Bluffs, IA · Local Education Agency (LEA) | $5.5M |
| 2 | 1629409867 | $5.5M |
| 3 | Goodwill Industries Of Northern New England Portland, ME · Clinic/Center Rehabilitation Comprehensive Outpatient Rehabilitation Facility (CORF) | $4.3M |
| 4 | 1699805283 | $4.3M |
| 5 | 1518094788 | $3.8M |
| 6 | 1467505602 | $3.8M |
| 7 | 1518019868 | $3.5M |
| 8 | 1033426739 | $3.3M |
| 9 | 1598812141 | $2.5M |
| 10 | 1932260841 | $2.4M |
| 11 | 1033294558 | $2.3M |
| 12 | 1689892473 | $2.0M |
| 13 | 1467509877 | $2.0M |
| 14 | Douglas A. Thom Clinic, Inc. Lowell, MA · Clinic/Center, Developmental Disabilities | $1.6M |
| 15 | 1881722437 | $1.5M |
| 16 | 1588869093 | $1.5M |
| 17 | Universal Rehabilitation And Fitness, Inc. Livingston, NJ · Clinic/Center, Rehabilitation | $1.2M |
| 18 | 1518186600 | $1.1M |
| 19 | 1376695320 | $1000K |
| 20 | 1265587042 | $972K |
Showing top 20 of 929 providers billing this code