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#2878 of 11K

98966

HCPCS Procedure Code

HCPCS code 98966 is the #2,878 most-billed Medicaid procedure code, with $3.2M in payments across 475K claims from 2018–2024. The national median cost per claim is $6.84. Costs vary widely — the 90th percentile is $23.74 per claim, 3.5× the median.

Total Paid

$3.2M

0.00% of all spending

Total Claims

475K

Providers

671

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for 98966? Based on 513 providers billing this code nationally.

Median

$6.84

Average

$14.85

Std Dev

$42.42

Max

$544.77

Percentile Distribution (Cost per Claim)

p10
$0.04
p25
$0.76
Median
$6.84
p75
$10.80
p90
$23.74
p95
$53.20
p99
$173.47

50% of providers bill between $0.76 and $10.80 per claim for this code.

90% bill between $0.04 and $23.74.

Top 1% bill above $173.47.

About This Procedure

HCPCS code 98966 was billed by 671 providers across 475K claims, totaling $3.2M in Medicaid payments from 2018–2024. This code was used for 349K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.84

Providers Billing

513

National Spending

$3.2M

Avg/Median Ratio

2.17×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 98966

#ProviderTotal Paid
1Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$666K
21174184709$573K
3Los Angeles County Department Of Mental Health

Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$191K
41598018806$187K
51780861062$146K
6Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$78K
71710049218$72K
8Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$70K
91467678706$69K
101306387949$67K
111417084708$66K
121962040246$36K
131982607537$34K
14United Health Services Hospitals, Inc.

Binghamton, NY · General Acute Care Hospital

$29K
151316040249$28K
161568576056$28K
171003824855$28K
181780158261$27K
191528233103$26K
201952476715$26K

Showing top 20 of 671 providers billing this code