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#1115 of 11K

99218

HCPCS Procedure Code

HCPCS code 99218 is the #1,115 most-billed Medicaid procedure code, with $39.7M in payments across 311K claims from 2018–2024. The national median cost per claim is $51.50. Costs vary widely — the 90th percentile is $171.10 per claim, 3.3× the median.

Total Paid

$39.7M

0.00% of all spending

Total Claims

311K

Providers

774

Avg Cost/Claim

$128

National Cost Distribution

How much do providers bill per claim for 99218? Based on 743 providers billing this code nationally.

Median

$51.50

Average

$87.25

Std Dev

$155.27

Max

$2,130.73

Percentile Distribution (Cost per Claim)

p10
$19.53
p25
$36.72
Median
$51.50
p75
$68.39
p90
$171.10
p95
$297.50
p99
$604.79

50% of providers bill between $36.72 and $68.39 per claim for this code.

90% bill between $19.53 and $171.10.

Top 1% bill above $604.79.

About This Procedure

HCPCS code 99218 was billed by 774 providers across 311K claims, totaling $39.7M in Medicaid payments from 2018–2024. This code was used for 228K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$51.50

Providers Billing

743

National Spending

$39.7M

Avg/Median Ratio

1.69×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99218

#ProviderTotal Paid
11467504555$4.2M
2The Health And Hospital Corporation Of Marion County

Indianapolis, IN · Psychiatric Unit

$3.5M
31184654923$3.1M
41114958584$2.9M
5Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$2.1M
61053361642$1.3M
7Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$1.0M
81003216391$967K
9The Queens Medical Center

Honolulu, HI · Psychiatric Unit

$853K
101356435341$592K
11Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$494K
121053382697$488K
131194368167$438K
141063812907$434K
151295772093$393K
161619038247$390K
171972503647$372K
181386749893$361K
191245390855$337K
20Southcoast Hospitals Group, Inc

New Bedford, MA · General Acute Care Hospital

$290K

Showing top 20 of 774 providers billing this code