97535
Self-care/home management training, per 15 minutes
Self-care/home management training, per 15 minutes is the #123 most-billed Medicaid procedure code, with $1.60B in payments across 21.9M claims from 2018–2024. The national median cost per claim is $18.18. Costs vary widely — the 90th percentile is $69.83 per claim, 3.8× the median.
Total Paid
$1.60B
0.15% of all spending
Total Claims
21.9M
Providers
5K
Avg Cost/Claim
$73
National Cost Distribution
How much do providers bill per claim for 97535? Based on 5K providers billing this code nationally.
Median
$18.18
Average
$28.93
Std Dev
$37.62
Max
$561.87
Percentile Distribution (Cost per Claim)
50% of providers bill between $8.41 and $31.93 per claim for this code.
90% bill between $2.52 and $69.83.
Top 1% bill above $170.46.
About This Procedure
HCPCS code 97535 (Self-care/home management training, per 15 minutes) was billed by 5K providers across 21.9M claims, totaling $1.60B in Medicaid payments from 2018–2024. This code was used for 4.6M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$18.18
Providers Billing
5K
National Spending
$1.60B
Avg/Median Ratio
1.59×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 97535
| # | Provider | Total Paid |
|---|---|---|
| 1 | Seven Counties Services Inc. Louisville, KY · Clinic/Center Developmental Disabilities | $215.2M |
| 2 | Cumberland River Behavioral Health Inc Corbin, KY · Community/Behavioral Health | $120.3M |
| 3 | New Vista Of The Bluegrass Inc Versailles, KY · Clinic/Center Mental Health (Including Community Mental Health Center) | $110.3M |
| 4 | Communicare Inc Elizabethtown, KY · Community/Behavioral Health | $100.5M |
| 5 | Lifeskills Inc Bowling Green, KY · Community/Behavioral Health | $84.5M |
| 6 | Pathways Inc. Ashland, KY · Clinic/Center Mental Health (Including Community Mental Health Center) | $56.0M |
| 7 | Green River Regional Mental Health/mental Retardation Board Inc. Owensboro, KY · Clinic/Center Developmental Disabilities | $48.6M |
| 8 | Lake Cumberland Reg Mhmr Board Inc. Somerset, KY · Community/Behavioral Health | $38.6M |
| 9 | 1750727798 | $30.6M |
| 10 | Lifeskills Inc. Hopkinsville, KY · Day Training Developmentally Disabled Services | $29.3M |
| 11 | 1437351376 | $20.8M |
| 12 | Kentucky River Community Care Inc Hazard, KY · Specialist | $19.9M |
| 13 | Bluegrass Area Development District Lexington, KY · Case Management | $19.0M |
| 14 | Green River Area Development District Owensboro, KY · Supports Brokerage | $18.1M |
| 15 | Western Ky Regional Mhmr Board Inc Paducah, KY · Clinic/Center Mental Health (Including Community Mental Health Center) | $17.4M |
| 16 | 1306240817 | $16.0M |
| 17 | Northern Kentucky Consumer Directed Option Program Florence, KY · Supports Brokerage | $15.5M |
| 18 | Mountain Comprehensive Care Center Prestonsburg, KY · Case Management | $15.0M |
| 19 | 1134152861 | $11.0M |
| 20 | 1962784249 | $9.9M |
Showing top 20 of 5K providers billing this code