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#230 of 11K

97150

Therapeutic procedure, group (2+ patients)

Therapeutic procedure, group (2+ patients) is the #230 most-billed Medicaid procedure code, with $643.8M in payments across 10.9M claims from 2018–2024. The national median cost per claim is $12.12. Costs vary widely — the 90th percentile is $29.71 per claim, 2.5× the median.

Total Paid

$643.8M

0.06% of all spending

Total Claims

10.9M

Providers

4K

Avg Cost/Claim

$59

National Cost Distribution

How much do providers bill per claim for 97150? Based on 3K providers billing this code nationally.

Median

$12.12

Average

$42.83

Std Dev

$172.44

Max

$2,578.36

Percentile Distribution (Cost per Claim)

p10
$2.98
p25
$6.30
Median
$12.12
p75
$17.68
p90
$29.71
p95
$92.92
p99
$1,029.09

50% of providers bill between $6.30 and $17.68 per claim for this code.

90% bill between $2.98 and $29.71.

Top 1% bill above $1,029.09.

About This Procedure

HCPCS code 97150 (Therapeutic procedure, group (2+ patients)) was billed by 4K providers across 10.9M claims, totaling $643.8M in Medicaid payments from 2018–2024. This code was used for 3.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.12

Providers Billing

3K

National Spending

$643.8M

Avg/Median Ratio

3.53×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 97150

#ProviderTotal Paid
11265470686$35.1M
2City Of New York

Brooklyn, NY · Local Education Agency (LEA)

$17.7M
31093768921$16.4M
4Soar 365

Richmond, VA · Day Training Developmentally Disabled Services

$14.7M
51447651070$14.3M
6Rappahannock Area Community Services Board

Fredericksburg, VA · Day Training, Developmentally Disabled Services

$13.5M
71730589805$11.1M
81235125055$10.1M
9Mount Rogers Community Services

Wytheville, VA · Clinic/Center Mental Health (Including Community Mental Health Center)

$10.0M
101922015577$9.4M
111063799807$9.3M
121205134319$9.0M
131568524627$8.7M
141467542415$8.5M
151467607580$7.9M
161528091063$7.9M
171568424364$7.8M
181073826319$7.7M
19Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$7.5M
20Heritage House Of Virginia Inc.

Stafford, VA · Residential Treatment Facility Intellectual and/or Developmental Disabilities

$7.2M

Showing top 20 of 4K providers billing this code