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

#623 of 11K

99401

HCPCS Procedure Code

HCPCS code 99401 is the #623 most-billed Medicaid procedure code, with $122.5M in payments across 7.8M claims from 2018–2024. The national median cost per claim is $16.53.

Total Paid

$122.5M

0.01% of all spending

Total Claims

7.8M

Providers

6K

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for 99401? Based on 5K providers billing this code nationally.

Median

$16.53

Average

$17.13

Std Dev

$14.58

Max

$245.42

Percentile Distribution (Cost per Claim)

p10
$1.21
p25
$6.86
Median
$16.53
p75
$24.54
p90
$30.46
p95
$35.41
p99
$63.43

50% of providers bill between $6.86 and $24.54 per claim for this code.

90% bill between $1.21 and $30.46.

Top 1% bill above $63.43.

About This Procedure

HCPCS code 99401 was billed by 6K providers across 7.8M claims, totaling $122.5M in Medicaid payments from 2018–2024. This code was used for 6.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.53

Providers Billing

5K

National Spending

$122.5M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99401

#ProviderTotal Paid
11114264660$2.9M
2New Horizon Counseling Center Inc

South Ozone Park, NY · Clinic/Center Mental Health (Including Community Mental Health Center)

$2.9M
3Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$2.9M
41780819748$1.9M
51790930618$1.5M
61427125269$1.5M
7Nys Office Of Mental Health

Orangeburg, NY · Clinic/Center, Adolescent and Children Mental Health

$1.4M
8Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$1.4M
9Sun River Health Inc.

Peekskill, NY · Clinic/Center Federally Qualified Health Center (FQHC)

$1.2M
101306078514$1.2M
111821597444$938K
121417061011$862K
131780619064$810K
141457640245$802K
151730246968$757K
161104804459$743K
171821454505$706K
18Behavioral Health Services North Inc.

Morrisonville, NY · Clinic/Center Mental Health (Including Community Mental Health Center)

$691K
191043346745$663K
201083623409$595K

Showing top 20 of 6K providers billing this code