#4669 of 11K

A7020

HCPCS Procedure Code

HCPCS code A7020 is the #4,669 most-billed Medicaid procedure code, with $459K in payments across 30K claims from 2018–2024. The national median cost per claim is $9.23. Costs vary widely — the 90th percentile is $22.16 per claim, 2.4× the median.

Total Paid

$459K

0.00% of all spending

Total Claims

30K

Providers

Avg Cost/Claim

$15

National Cost Distribution

How much do providers bill per claim for A7020? Based on 35 providers billing this code nationally.

Median

$9.23

Average

$11.21

Std Dev

$7.83

Max

$33.09

Percentile Distribution (Cost per Claim)

p10

$3.31

p25

$6.85

Median

$9.23

p75

$12.72

p90

$22.16

p95

$27.88

p99

$32.29

50% of providers bill between $6.85 and $12.72 per claim for this code.

90% bill between $3.31 and $22.16.

Top 1% bill above $32.29.

About This Procedure

HCPCS code A7020 was billed by 35 providers across 30K claims, totaling $459K in Medicaid payments from 2018–2024. This code was used for 26K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.23

Providers Billing

National Spending

$459K

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A7020

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	The Promptcare Companies, Inc. King Of Prussia, PA · Durable Medical Equipment & Medical Supplies	$99K	$26.66	2.9× median	Top 10%
2	Pediatric Home Respiratory Services Llc Roseville, MN · Home Health	$95K	$18.15	2.0× median	Above 75th
3	Advanced Respiratory, Inc. Saint Paul, MN · Durable Medical Equipment & Medical Supplies	$88K	$13.22	1.4× median	Above 75th
4	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$62K	$30.75	3.3× median	Top 10%
5	1316364011	$24K	$22.56	2.4× median	Top 10%
6	1083615991	$20K	$9.76	1.1× median	Above Median
7	1902137409	$11K	$12.22	1.3× median	Above Median
8	1558755371	$10K	$8.36	0.9× median	Below Median
9	1902098965	$6K	$6.56	0.7× median	Below Median
10	Integra Partners Llc Troy, MI · Orthotic Fitter	$6K	$13.76	1.5× median	Above 75th
11	1205837879	$6K	$21.56	2.3× median	Above 75th
12	1326140138	$6K	$7.12	0.8× median	Below Median
13	Los Ninos Hospital Inc Phoenix, AZ · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$5K	$11.38	1.2× median	Above Median
14	1376519918	$5K	$5.42	0.6× median	Below Median
15	1962459537	$4K	$6.57	0.7× median	Below Median
16	1306961792	$3K	$11.66	1.3× median	Above Median
17	Medcare Equipment Company Llc Erie, PA · Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies	$2K	$33.09	3.6× median	Top 1%
18	1134713597	$2K	$9.23	1.0× median	Above Median
19	1235329228	$1K	$5.12	0.6× median	Below Median
20	1285639914	$852	$8.87	1.0× median	Below Median

Showing top 20 of 35 providers billing this code

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