G0396
Alcohol/substance abuse structured assessment, 15-30 minutes
Alcohol/substance abuse structured assessment, 15-30 minutes is the #480 most-billed Medicaid procedure code, with $194.8M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $40.58. Costs vary widely — the 90th percentile is $114.43 per claim, 2.8× the median.
Total Paid
$194.8M
0.02% of all spending
Total Claims
2.0M
Providers
693
Avg Cost/Claim
$97
National Cost Distribution
How much do providers bill per claim for G0396? Based on 569 providers billing this code nationally.
Median
$40.58
Average
$50.97
Std Dev
$50.52
Max
$397.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.87 and $99.91 per claim for this code.
90% bill between $1.63 and $114.43.
Top 1% bill above $156.57.
About This Procedure
HCPCS code G0396 (Alcohol/substance abuse structured assessment, 15-30 minutes) was billed by 693 providers across 2.0M claims, totaling $194.8M in Medicaid payments from 2018–2024. This code was used for 1.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$40.58
Providers Billing
569
National Spending
$194.8M
Avg/Median Ratio
1.26×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for G0396
| # | Provider | Total Paid |
|---|---|---|
| 1 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $14.7M |
| 2 | Beth Israel Medical Center Brooklyn, NY · Psychiatric Unit | $12.7M |
| 3 | Counseling Service Of Edny Inc. Brooklyn, NY · Clinic/Center Mental Health (Including Community Mental Health Center) | $9.5M |
| 4 | 1679883037 | $7.9M |
| 5 | 1689891178 | $7.6M |
| 6 | 1043385578 | $7.3M |
| 7 | Vertex Llc Bronx, NY · Clinic/Center Rehabilitation Substance Use Disorder | $6.9M |
| 8 | 1740366749 | $6.1M |
| 9 | 1538180351 | $5.5M |
| 10 | 1134593510 | $5.5M |
| 11 | 1487709671 | $5.0M |
| 12 | 1083618672 | $4.4M |
| 13 | 1578526695 | $4.4M |
| 14 | 1437221355 | $3.9M |
| 15 | 1407877137 | $3.2M |
| 16 | University Of Rochester Rochester, NY · General Acute Care Hospital | $3.1M |
| 17 | 1124131685 | $3.0M |
| 18 | 1235206327 | $2.8M |
| 19 | 1609805993 | $2.7M |
| 20 | 1194035709 | $2.5M |
Showing top 20 of 693 providers billing this code