97153
Adaptive behavior treatment by protocol, per 15 min
Adaptive behavior treatment by protocol, per 15 min is the #37 most-billed Medicaid procedure code, with $5.15B in payments across 26.0M claims from 2018–2024. The national median cost per claim is $167.38.
Total Paid
$5.15B
0.47% of all spending
Total Claims
26.0M
Providers
2K
Avg Cost/Claim
$198
National Cost Distribution
How much do providers bill per claim for 97153? Based on 2K providers billing this code nationally.
Median
$167.38
Average
$200.99
Std Dev
$211.66
Max
$4,711.51
Percentile Distribution (Cost per Claim)
50% of providers bill between $113.87 and $236.26 per claim for this code.
90% bill between $77.58 and $331.94.
Top 1% bill above $826.48.
About This Procedure
HCPCS code 97153 (Adaptive behavior treatment by protocol, per 15 min) was billed by 2K providers across 26.0M claims, totaling $5.15B in Medicaid payments from 2018–2024. This code was used for 2.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$167.38
Providers Billing
2K
National Spending
$5.15B
Avg/Median Ratio
1.20×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97153
| # | Provider | Total Paid |
|---|---|---|
| 1 | Centria Healthcare Llc Farmington Hills, MI · Home Health | $345.5M |
| 2 | Vav Operations Llc South Bend, IN · Community/Behavioral Health | $179.0M |
| 3 | Abs Utah P.c. Salt Lake City, UT · Community/Behavioral Health | $160.5M |
| 4 | Comprehab Llc Gastonia, NC · Speech-Language Pathologist, | $92.6M |
| 5 | Hopebridge, Llc Kokomo, IN · Assistant Behavior Analyst | $86.7M |
| 6 | Gateway Pediatric Therapy Llc Bingham Farms, MI · Behavior Analyst | $80.0M |
| 7 | 1144682873 | $68.7M |
| 8 | Eric Lund Green Bay, WI · Psychologist Clinical | $54.9M |
| 9 | Brett Dinovi & Associates Pa Llc Bensalem, PA · Behavior Analyst | $53.1M |
| 10 | 1962765693 | $48.0M |
| 11 | Behavior Interventions, Inc King Of Prussia, PA · Behavior Analyst | $42.8M |
| 12 | 1558841163 | $42.1M |
| 13 | 1104119619 | $41.9M |
| 14 | 1275032096 | $41.8M |
| 15 | 1609194000 | $41.4M |
| 16 | 1770706160 | $41.3M |
| 17 | 1760977649 | $40.3M |
| 18 | 1427154814 | $39.8M |
| 19 | 1366047474 | $38.8M |
| 20 | 1033663430 | $38.8M |
Showing top 20 of 2K providers billing this code