99254
HCPCS Procedure Code
HCPCS code 99254 is the #800 most-billed Medicaid procedure code, with $77.8M in payments across 797K claims from 2018–2024. The national median cost per claim is $81.43.
Total Paid
$77.8M
0.01% of all spending
Total Claims
797K
Providers
2K
Avg Cost/Claim
$98
National Cost Distribution
How much do providers bill per claim for 99254? Based on 2K providers billing this code nationally.
Median
$81.43
Average
$90.92
Std Dev
$62.95
Max
$1,622.69
Percentile Distribution (Cost per Claim)
50% of providers bill between $61.89 and $113.93 per claim for this code.
90% bill between $45.62 and $142.68.
Top 1% bill above $238.18.
About This Procedure
HCPCS code 99254 was billed by 2K providers across 797K claims, totaling $77.8M in Medicaid payments from 2018–2024. This code was used for 736K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$81.43
Providers Billing
2K
National Spending
$77.8M
Avg/Median Ratio
1.12×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99254
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1366621930 | $5.4M |
| 2 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $2.5M |
| 3 | 1073771861 | $1.9M |
| 4 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $1.9M |
| 5 | 1750560322 | $1.4M |
| 6 | 1548240443 | $1.3M |
| 7 | 1750343216 | $1.1M |
| 8 | 1881068898 | $1.0M |
| 9 | 1447299797 | $1.0M |
| 10 | County Of San Diego San Diego, CA · Public Health or Welfare | $843K |
| 11 | 1609804541 | $781K |
| 12 | 1811920549 | $770K |
| 13 | 1750487344 | $746K |
| 14 | 1225582620 | $734K |
| 15 | 1043791981 | $710K |
| 16 | 1023328945 | $671K |
| 17 | 1124516273 | $630K |
| 18 | 1992084677 | $617K |
| 19 | 1629006002 | $571K |
| 20 | Texas Children's Physician Group Houston, TX · Pediatrics | $483K |
Showing top 20 of 2K providers billing this code