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#4024 of 11K

G0109

Diabetes self-management training, group

Diabetes self-management training, group is the #4,024 most-billed Medicaid procedure code, with $920K in payments across 34K claims from 2018–2024. The national median cost per claim is $27.23. Costs vary widely — the 90th percentile is $60.84 per claim, 2.2× the median.

Total Paid

$920K

0.00% of all spending

Total Claims

34K

Providers

94

Avg Cost/Claim

$27

National Cost Distribution

How much do providers bill per claim for G0109? Based on 88 providers billing this code nationally.

Median

$27.23

Average

$34.57

Std Dev

$37.84

Max

$310.48

Percentile Distribution (Cost per Claim)

p10
$6.76
p25
$17.45
Median
$27.23
p75
$39.64
p90
$60.84
p95
$84.03
p99
$167.64

50% of providers bill between $17.45 and $39.64 per claim for this code.

90% bill between $6.76 and $60.84.

Top 1% bill above $167.64.

About This Procedure

HCPCS code G0109 (Diabetes self-management training, group) was billed by 94 providers across 34K claims, totaling $920K in Medicaid payments from 2018–2024. This code was used for 24K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.23

Providers Billing

88

National Spending

$920K

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0109

#ProviderTotal Paid
1Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$100K
2Arrowhead Regional Medical Center

Colton, CA · General Acute Care Hospital

$87K
31861409823$70K
41093158347$56K
5The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$45K
61396292280$43K
71780004358$43K
8Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$36K
91598717480$34K
101063441293$34K
11Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$34K
12Upmc Children's Hospital Of Pittsburgh

Pittsburgh, PA · Clinic/Center

$23K
131407100183$21K
141265689111$20K
15Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$19K
161487297958$17K
17Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$16K
18Bakersfield Memorial Hospital

Bakersfield, CA · General Acute Care Hospital

$15K
19Indiana University Health Care Associates, Inc

Indianapolis, IN · Physician Assistant

$13K
201427360700$12K

Showing top 20 of 94 providers billing this code