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#1743 of 11K

G0155

Services of clinical social worker in home health, per 15 min

Services of clinical social worker in home health, per 15 min is the #1,743 most-billed Medicaid procedure code, with $14.9M in payments across 952K claims from 2018–2024. The national median cost per claim is $7.04. Costs vary widely — the 90th percentile is $139.54 per claim, 19.8× the median.

Total Paid

$14.9M

0.00% of all spending

Total Claims

952K

Providers

881

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for G0155? Based on 396 providers billing this code nationally.

Median

$7.04

Average

$48.07

Std Dev

$74.74

Max

$578.11

Percentile Distribution (Cost per Claim)

p10
$0.08
p25
$0.37
Median
$7.04
p75
$78.99
p90
$139.54
p95
$173.87
p99
$289.03

50% of providers bill between $0.37 and $78.99 per claim for this code.

90% bill between $0.08 and $139.54.

Top 1% bill above $289.03.

About This Procedure

HCPCS code G0155 (Services of clinical social worker in home health, per 15 min) was billed by 881 providers across 952K claims, totaling $14.9M in Medicaid payments from 2018–2024. This code was used for 567K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.04

Providers Billing

396

National Spending

$14.9M

Avg/Median Ratio

6.83×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for G0155

#ProviderTotal Paid
11417058397$2.5M
21083643944$1.5M
31841591062$532K
41124173059$468K
51245437920$455K
61790869568$450K
71720147408$446K
81245236306$393K
91598828436$364K
101598810509$356K
111912052838$334K
121871144725$322K
131649209412$310K
141245385244$289K
151184013369$269K
161801921853$267K
171275510844$265K
181982829537$239K
191194899138$237K
201861464471$227K

Showing top 20 of 881 providers billing this code