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#86 of 11K

G9012

Other specified case management service, per 15 minutes

Other specified case management service, per 15 minutes is the #86 most-billed Medicaid procedure code, with $2.25B in payments across 20.9M claims from 2018–2024. The national median cost per claim is $137.85. Costs vary widely — the 90th percentile is $288.76 per claim, 2.1× the median.

Total Paid

$2.25B

0.21% of all spending

Total Claims

20.9M

Providers

2K

Avg Cost/Claim

$108

National Cost Distribution

How much do providers bill per claim for G9012? Based on 1K providers billing this code nationally.

Median

$137.85

Average

$166.47

Std Dev

$131.50

Max

$1,020.97

Percentile Distribution (Cost per Claim)

p10
$22.61
p25
$59.06
Median
$137.85
p75
$265.49
p90
$288.76
p95
$366.90
p99
$608.49

50% of providers bill between $59.06 and $265.49 per claim for this code.

90% bill between $22.61 and $288.76.

Top 1% bill above $608.49.

About This Procedure

HCPCS code G9012 (Other specified case management service, per 15 minutes) was billed by 2K providers across 20.9M claims, totaling $2.25B in Medicaid payments from 2018–2024. This code was used for 8.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$137.85

Providers Billing

1K

National Spending

$2.25B

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G9012

#ProviderTotal Paid
1State Of Oklahoma Dept Of Human Services

Oklahoma City, OK · Case Management

$224.5M
2State Of Oklahoma Dept. Of Human Services

Oklahoma City, OK · Case Management

$187.3M
3State Of Missouri

Saint Louis, MO · Case Management

$78.4M
4Ars Treatment Centers, P.c.

Uniontown, PA · Anesthesiology

$46.2M
51861521809$46.0M
61649809526$41.4M
71861662827$41.2M
81366807760$33.6M
91366576514$33.5M
10Handicap Facilities Of St Charles County

St Peters, MO · Case Management

$29.6M
11American Truecare, Inc

San Diego, CA · Case Management

$26.8M
121003186156$24.5M
131831239383$23.0M
141831237080$21.3M
151548739170$18.4M
161669782850$17.7M
171073644076$17.4M
18Independent Living Systems Llc

Miami, FL · Case Management

$16.2M
191952328700$15.7M
20Full Circle Health Network

Sacramento, CA · Supports Brokerage

$15.1M

Showing top 20 of 2K providers billing this code