96164
HCPCS Procedure Code
HCPCS code 96164 is the #818 most-billed Medicaid procedure code, with $73.4M in payments across 5.4M claims from 2018–2024. The national median cost per claim is $9.87. Costs vary widely — the 90th percentile is $19.81 per claim, 2.0× the median.
Total Paid
$73.4M
0.01% of all spending
Total Claims
5.4M
Providers
920
Avg Cost/Claim
$14
National Cost Distribution
How much do providers bill per claim for 96164? Based on 882 providers billing this code nationally.
Median
$9.87
Average
$11.43
Std Dev
$8.44
Max
$118.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.38 and $13.80 per claim for this code.
90% bill between $3.65 and $19.81.
Top 1% bill above $42.29.
About This Procedure
HCPCS code 96164 was billed by 920 providers across 5.4M claims, totaling $73.4M in Medicaid payments from 2018–2024. This code was used for 1.7M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.87
Providers Billing
882
National Spending
$73.4M
Avg/Median Ratio
1.16×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 96164
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Board Of Education Of The City Of Chicago Chicago, IL · Local Education Agency (LEA) | $6.2M |
| 2 | 1629409867 | $2.1M |
| 3 | 1164586210 | $2.0M |
| 4 | 1033426739 | $1.7M |
| 5 | 1588869093 | $1.7M |
| 6 | 1639693781 | $1.5M |
| 7 | 1669645073 | $1.5M |
| 8 | 1518186600 | $1.4M |
| 9 | Universal Rehabilitation And Fitness, Inc. Livingston, NJ · Clinic/Center, Rehabilitation | $1.1M |
| 10 | Goodwill Industries Of Northern New England Portland, ME · Clinic/Center Rehabilitation Comprehensive Outpatient Rehabilitation Facility (CORF) | $959K |
| 11 | Council Bluffs Community School District Council Bluffs, IA · Local Education Agency (LEA) | $880K |
| 12 | 1689892473 | $875K |
| 13 | 1790153682 | $785K |
| 14 | 1124159157 | $759K |
| 15 | Los Angeles Unified School District Los Angeles, CA · Social Worker School | $737K |
| 16 | 1801018528 | $684K |
| 17 | 1376696096 | $667K |
| 18 | 1013030147 | $635K |
| 19 | 1598812141 | $628K |
| 20 | 1891823217 | $628K |
Showing top 20 of 920 providers billing this code