#2917 of 11K

99409

HCPCS Procedure Code

HCPCS code 99409 is the #2,917 most-billed Medicaid procedure code, with $3.0M in payments across 106K claims from 2018–2024. The national median cost per claim is $34.77.

Total Paid

$3.0M

0.00% of all spending

Total Claims

106K

Providers

181

Avg Cost/Claim

$29

National Cost Distribution

How much do providers bill per claim for 99409? Based on 129 providers billing this code nationally.

Median

$34.77

Average

$36.38

Std Dev

$58.10

Max

$646.89

Percentile Distribution (Cost per Claim)

p10

$1.37

p25

$13.25

Median

$34.77

p75

$44.67

p90

$59.43

p95

$65.48

p99

$90.08

50% of providers bill between $13.25 and $44.67 per claim for this code.

90% bill between $1.37 and $59.43.

Top 1% bill above $90.08.

About This Procedure

HCPCS code 99409 was billed by 181 providers across 106K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 68K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.77

Providers Billing

129

National Spending

$3.0M

Avg/Median Ratio

1.05×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99409

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1003041534	$581K	$57.00	1.6× median	Above 75th
2	1356854400	$285K	$26.97	0.8× median	Below Median
3	Richmond Behavioral Health Authority Richmond, VA · Counselor	$244K	$16.56	0.5× median	Below Median
4	1710527767	$214K	$68.13	2.0× median	Top 10%
5	1437668985	$168K	$35.40	1.0× median	Above Median
6	1295253110	$131K	$44.36	1.3× median	Above Median
7	Banyan Delaware Llc Milford, DE · Clinic/Center, Rehabilitation, Substance Use Disorder	$129K	$50.54	1.5× median	Above 75th
8	1336694694	$127K	$59.52	1.7× median	Top 10%
9	1821126004	$92K	$37.85	1.1× median	Above Median
10	1023721065	$87K	$22.44	0.6× median	Below Median
11	1598135451	$71K	$55.09	1.6× median	Above 75th
12	1730377342	$61K	$39.57	1.1× median	Above Median
13	1083053151	$61K	$42.91	1.2× median	Above Median
14	1700062296	$60K	$646.89	18.6× median	Top 1%
15	1265949788	$58K	$42.65	1.2× median	Above Median
16	1295211126	$52K	$42.83	1.2× median	Above Median
17	1588389944	$46K	$23.32	0.7× median	Below Median
18	1083781207	$39K	$42.13	1.2× median	Above Median
19	1487203303	$30K	$31.85	0.9× median	Below Median
20	1922300706	$29K	$36.95	1.1× median	Above Median

Showing top 20 of 181 providers billing this code

Related Procedures

99401$122.5M 99402$94.5M 99406$36.4M 99417$33.2M 99408$30.5M

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