Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#549 of 11K

97803

Medical nutrition therapy, reassessment, group, thirty minutes

Medical nutrition therapy, reassessment, group, thirty minutes is the #549 most-billed Medicaid procedure code, with $151.3M in payments across 5.8M claims from 2018–2024. The national median cost per claim is $24.33. Costs vary widely — the 90th percentile is $81.35 per claim, 3.3× the median.

Total Paid

$151.3M

0.01% of all spending

Total Claims

5.8M

Providers

4K

Avg Cost/Claim

$26

National Cost Distribution

How much do providers bill per claim for 97803? Based on 3K providers billing this code nationally.

Median

$24.33

Average

$34.73

Std Dev

$43.10

Max

$719.00

Percentile Distribution (Cost per Claim)

p10
$0.44
p25
$5.12
Median
$24.33
p75
$49.69
p90
$81.35
p95
$99.59
p99
$185.30

50% of providers bill between $5.12 and $49.69 per claim for this code.

90% bill between $0.44 and $81.35.

Top 1% bill above $185.30.

About This Procedure

HCPCS code 97803 (Medical nutrition therapy, reassessment, group, thirty minutes) was billed by 4K providers across 5.8M claims, totaling $151.3M in Medicaid payments from 2018–2024. This code was used for 4.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$24.33

Providers Billing

3K

National Spending

$151.3M

Avg/Median Ratio

1.43×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 97803

#ProviderTotal Paid
11003011602$9.7M
21851652739$4.8M
31902299639$3.9M
41083850226$2.5M
5Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$2.1M
61336245828$2.1M
7Children's Hospital Corporation

Boston, MA · Clinic/Center

$2.0M
8Nv St Dv Mh Ds Desert Dev Center

Las Vegas, NV · Respite Care Respite Care Intellectual and/or Developmental Disabilities Child

$1.8M
91104935378$1.6M
10Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$1.5M
11Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$1.4M
12Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$1.4M
131154586253$1.3M
141205928751$1.2M
151164917282$1.1M
16Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$1.1M
171750884516$1.1M
18The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$1.0M
191962587964$1.0M
201871935254$992K

Showing top 20 of 4K providers billing this code