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#2384 of 11K

99421

Online digital E/M, 5-10 min

Online digital E/M, 5-10 min is the #2,384 most-billed Medicaid procedure code, with $6.2M in payments across 267K claims from 2018–2024. The national median cost per claim is $9.42. Costs vary widely — the 90th percentile is $19.00 per claim, 2.0× the median.

Total Paid

$6.2M

0.00% of all spending

Total Claims

267K

Providers

545

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for 99421? Based on 456 providers billing this code nationally.

Median

$9.42

Average

$14.74

Std Dev

$53.63

Max

$809.25

Percentile Distribution (Cost per Claim)

p10
$0.77
p25
$4.51
Median
$9.42
p75
$14.37
p90
$19.00
p95
$25.79
p99
$81.35

50% of providers bill between $4.51 and $14.37 per claim for this code.

90% bill between $0.77 and $19.00.

Top 1% bill above $81.35.

About This Procedure

HCPCS code 99421 (Online digital E/M, 5-10 min) was billed by 545 providers across 267K claims, totaling $6.2M in Medicaid payments from 2018–2024. This code was used for 206K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.42

Providers Billing

456

National Spending

$6.2M

Avg/Median Ratio

1.56×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 99421

#ProviderTotal Paid
11669792990$2.0M
21417263922$1.9M
31821074535$248K
4Kaiser Foundation Health Plan Of The Northwest

Portland, OR · General Practice

$224K
51043287287$121K
61730626359$94K
71295861557$82K
81497992770$71K
91174931448$57K
101720376304$50K
11Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$47K
121972797256$46K
131912975251$42K
141881714384$42K
151992178115$42K
161609930809$41K
171043982671$38K
181164679494$37K
19Southern California Permanente Medical Group

San Diego, CA · Health Maintenance Organization

$35K
201447639265$31K

Showing top 20 of 545 providers billing this code