97530
Therapeutic activities, each 15 min
Therapeutic activities, each 15 min is the #29 most-billed Medicaid procedure code, with $6.22B in payments across 126.2M claims from 2018–2024. The national median cost per claim is $33.11. Costs vary widely — the 90th percentile is $83.31 per claim, 2.5× the median.
Total Paid
$6.22B
0.57% of all spending
Total Claims
126.2M
Providers
22K
Avg Cost/Claim
$49
National Cost Distribution
How much do providers bill per claim for 97530? Based on 21K providers billing this code nationally.
Median
$33.11
Average
$41.35
Std Dev
$37.48
Max
$1,439.88
Percentile Distribution (Cost per Claim)
50% of providers bill between $15.80 and $60.09 per claim for this code.
90% bill between $6.39 and $83.31.
Top 1% bill above $141.58.
About This Procedure
HCPCS code 97530 (Therapeutic activities, each 15 min) was billed by 22K providers across 126.2M claims, totaling $6.22B in Medicaid payments from 2018–2024. This code was used for 35.4M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$33.11
Providers Billing
21K
National Spending
$6.22B
Avg/Median Ratio
1.25×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97530
| # | Provider | Total Paid |
|---|---|---|
| 1 | City Of New York Brooklyn, NY · Local Education Agency (LEA) | $80.9M |
| 2 | Commonwealth Of Pennsylvania Department Of Education West Hazleton, PA · Local Education Agency (LEA) | $58.5M |
| 3 | 1912166075 | $53.0M |
| 4 | Wv Birth To Three Charleston, WV · Early Intervention Provider Agency | $44.2M |
| 5 | Children's Specialized Hospital New Brunswick, NJ · Pediatrics | $41.9M |
| 6 | New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization | $35.4M |
| 7 | 1497810576 | $29.8M |
| 8 | Kid Success Inc. Conway, AR · Clinic/Center Rehabilitation | $21.7M |
| 9 | Nyc Department Of Education New York, NY · Local Education Agency (LEA) | $20.0M |
| 10 | 1790085934 | $18.9M |
| 11 | Buck Jack Llc Colorado Springs, CO · Occupational Therapist | $17.8M |
| 12 | 1871570309 | $16.8M |
| 13 | 1316940505 | $16.6M |
| 14 | 1942359781 | $16.5M |
| 15 | 1851490627 | $15.7M |
| 16 | 1659485936 | $15.7M |
| 17 | Friendship Community Care Inc. Russellville, AR · Clinic/Center Rehabilitation Comprehensive Outpatient Rehabilitation Facility (CORF) | $15.6M |
| 18 | 1902808470 | $14.5M |
| 19 | 1831420033 | $14.1M |
| 20 | 1407129745 | $13.5M |
Showing top 20 of 22K providers billing this code