96160
Patient-focused health risk assessment
Patient-focused health risk assessment is the #1,058 most-billed Medicaid procedure code, with $45.1M in payments across 11.2M claims from 2018–2024. The national median cost per claim is $2.10. Costs vary widely — the 90th percentile is $14.09 per claim, 6.7× the median.
Total Paid
$45.1M
0.00% of all spending
Total Claims
11.2M
Providers
8K
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for 96160? Based on 6K providers billing this code nationally.
Median
$2.10
Average
$5.24
Std Dev
$15.28
Max
$532.89
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.81 and $3.88 per claim for this code.
90% bill between $0.12 and $14.09.
Top 1% bill above $40.88.
About This Procedure
HCPCS code 96160 (Patient-focused health risk assessment) was billed by 8K providers across 11.2M claims, totaling $45.1M in Medicaid payments from 2018–2024. This code was used for 9.7M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.10
Providers Billing
6K
National Spending
$45.1M
Avg/Median Ratio
2.50×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 96160
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $1.3M |
| 2 | 1992144380 | $1.3M |
| 3 | 1578772356 | $1.3M |
| 4 | 1740242957 | $1.1M |
| 5 | 1306877279 | $810K |
| 6 | 1942515440 | $787K |
| 7 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $749K |
| 8 | 1043285729 | $635K |
| 9 | 1215364633 | $517K |
| 10 | 1750305017 | $511K |
| 11 | 1881661866 | $447K |
| 12 | 1861530750 | $444K |
| 13 | 1740782788 | $410K |
| 14 | 1215054754 | $357K |
| 15 | 1063507747 | $345K |
| 16 | 1467678706 | $345K |
| 17 | 1063459410 | $344K |
| 18 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $299K |
| 19 | 1801073176 | $282K |
| 20 | 1053612911 | $270K |
Showing top 20 of 8K providers billing this code