G9005
Coordinated care fee, risk-adjusted, ESRD
Coordinated care fee, risk-adjusted, ESRD is the #95 most-billed Medicaid procedure code, with $2.08B in payments across 12.9M claims from 2018–2024. The national median cost per claim is $47.08. Costs vary widely — the 90th percentile is $451.60 per claim, 9.6× the median.
Total Paid
$2.08B
0.19% of all spending
Total Claims
12.9M
Providers
220
Avg Cost/Claim
$161
National Cost Distribution
How much do providers bill per claim for G9005? Based on 160 providers billing this code nationally.
Median
$47.08
Average
$156.01
Std Dev
$163.20
Max
$453.45
Percentile Distribution (Cost per Claim)
50% of providers bill between $26.66 and $307.05 per claim for this code.
90% bill between $11.62 and $451.60.
Top 1% bill above $453.24.
About This Procedure
HCPCS code G9005 (Coordinated care fee, risk-adjusted, ESRD) was billed by 220 providers across 12.9M claims, totaling $2.08B in Medicaid payments from 2018–2024. This code was used for 10.7M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$47.08
Providers Billing
160
National Spending
$2.08B
Avg/Median Ratio
3.31×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for G9005
| # | Provider | Total Paid |
|---|---|---|
| 1 | Coordinated Behavioral Care Inc New York, NY · Case Management | $288.4M |
| 2 | Community Care Management Partners Llc (Ccmp) New York, NY · Case Management | $226.9M |
| 3 | Srh Chn Lead Health Home Llc Peekskill, NY · Case Management | $209.0M |
| 4 | Sun River Health Inc. Peekskill, NY · Clinic/Center Federally Qualified Health Center (FQHC) | $161.8M |
| 5 | North Shore University Hospital New Hyde Park, NY · Case Management | $130.9M |
| 6 | Southwest Brooklyn Health Home Llc Brooklyn, NY · Case Management | $109.2M |
| 7 | Hudson Valley Care Coalition Ossining, NY · Case Management | $80.3M |
| 8 | Community Healthcare Network Inc New York, NY · Case Management | $75.7M |
| 9 | Huther Doyle Memorial Institute Rochester, NY · Case Management | $73.2M |
| 10 | Montefiore Medical Center Yonkers, NY · Case Management | $68.4M |
| 11 | Onondaga Case Management Services Inc. Syracuse, NY · Case Management | $63.6M |
| 12 | Bestself Behavioral Health Inc. Buffalo, NY · Clinic/Center Mental Health (Including Community Mental Health Center) | $57.6M |
| 13 | Greater Rochester Health Home Network Llc Rochester, NY · Case Management | $55.2M |
| 14 | Cnyhhn Inc Utica, NY · Case Management | $54.6M |
| 15 | Samaritan Hospital Of Troy, New York Troy, NY | $43.4M |
| 16 | Greater Buffalo United Ipa Buffalo, NY · Case Management | $41.5M |
| 17 | 1740557735 | $37.5M |
| 18 | New York City Health And Hospital Corporation New York, NY · Case Management | $31.6M |
| 19 | 1215292305 | $31.1M |
| 20 | Cinq-ny Health Home Ipa Llc Buffalo, NY · Clinic/Center Multi-Specialty | $26.2M |
Showing top 20 of 220 providers billing this code