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#448 of 11K

G0470

Chronic care management services, FQHC/RHC

Chronic care management services, FQHC/RHC is the #448 most-billed Medicaid procedure code, with $218.9M in payments across 2.8M claims from 2018–2024. The national median cost per claim is $45.95. Costs vary widely — the 90th percentile is $149.03 per claim, 3.2× the median.

Total Paid

$218.9M

0.02% of all spending

Total Claims

2.8M

Providers

941

Avg Cost/Claim

$77

National Cost Distribution

How much do providers bill per claim for G0470? Based on 816 providers billing this code nationally.

Median

$45.95

Average

$66.84

Std Dev

$80.99

Max

$629.23

Percentile Distribution (Cost per Claim)

p10
$5.61
p25
$21.78
Median
$45.95
p75
$73.80
p90
$149.03
p95
$199.33
p99
$466.51

50% of providers bill between $21.78 and $73.80 per claim for this code.

90% bill between $5.61 and $149.03.

Top 1% bill above $466.51.

About This Procedure

HCPCS code G0470 (Chronic care management services, FQHC/RHC) was billed by 941 providers across 2.8M claims, totaling $218.9M in Medicaid payments from 2018–2024. This code was used for 1.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$45.95

Providers Billing

816

National Spending

$218.9M

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0470

#ProviderTotal Paid
1Lynn Community Health, Inc.

Lynn, MA · Clinic/Center, Community Health

$12.5M
21578680310$9.9M
31477721058$7.0M
41396054169$6.7M
51952307530$6.5M
61811065576$5.5M
71598202913$5.1M
81124052816$4.6M
91689693343$4.1M
101376040881$3.9M
111790869436$3.8M
121033157771$3.6M
131669530986$3.6M
141518945278$3.5M
151497833271$3.4M
161821193145$3.2M
171073711057$3.1M
181891953048$2.9M
191326055450$2.7M
201497148407$2.6M

Showing top 20 of 941 providers billing this code