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#1020 of 11K

A0160

HCPCS Procedure Code

HCPCS code A0160 is the #1,020 most-billed Medicaid procedure code, with $47.5M in payments across 1.7M claims from 2018–2024. The national median cost per claim is $12.60. Costs vary widely — the 90th percentile is $54.43 per claim, 4.3× the median.

Total Paid

$47.5M

0.00% of all spending

Total Claims

1.7M

Providers

371

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for A0160? Based on 346 providers billing this code nationally.

Median

$12.60

Average

$27.66

Std Dev

$45.01

Max

$322.93

Percentile Distribution (Cost per Claim)

p10
$2.51
p25
$6.70
Median
$12.60
p75
$27.06
p90
$54.43
p95
$134.99
p99
$230.39

50% of providers bill between $6.70 and $27.06 per claim for this code.

90% bill between $2.51 and $54.43.

Top 1% bill above $230.39.

About This Procedure

HCPCS code A0160 was billed by 371 providers across 1.7M claims, totaling $47.5M in Medicaid payments from 2018–2024. This code was used for 517K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.60

Providers Billing

346

National Spending

$47.5M

Avg/Median Ratio

2.20×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A0160

#ProviderTotal Paid
1Public Partnerships Llc

Alpharetta, GA · Supports Brokerage

$9.7M
2Rem Community Options Inc.

Benwood, WV · Community/Behavioral Health

$2.3M
3Diversified Assessment & Therapy Services

Kenova, WV · Community/Behavioral Health

$1.9M
4Autism Service Center

Huntington, WV · Clinic/Center Developmental Disabilities

$1.4M
51164614301$1.4M
61720273170$1.4M
71518953652$1.3M
8Central West Virginia Aging Services Inc (Hmkr)

Buckhannon, WV · Home Health

$1.2M
9Rscr West Virginia Inc.

Parkersburg, WV · Clinic/Center Developmental Disabilities

$1.2M
10Voca Corporation Of West Virginia Inc.

Princeton, WV · Clinic/Center Developmental Disabilities

$1.1M
111366656225$1.1M
121134126147$943K
131649475914$912K
14West Virginia's Choice

Morgantown, WV · Home Health

$862K
15Linx Community Service Llc

Williamstown, WV · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities

$708K
161457497000$688K
171265727291$652K
181013327048$581K
191366600439$570K
20Eastern Panhandle Mental Health Center (Waiver)

Martinsburg, WV · Community/Behavioral Health

$516K

Showing top 20 of 371 providers billing this code