H0015
Alcohol and/or drug abuse, intensive outpatient, per hour
Alcohol and/or drug abuse, intensive outpatient, per hour is the #53 most-billed Medicaid procedure code, with $3.81B in payments across 25.1M claims from 2018–2024. The national median cost per claim is $129.75.
Total Paid
$3.81B
0.35% of all spending
Total Claims
25.1M
Providers
3K
Avg Cost/Claim
$152
National Cost Distribution
How much do providers bill per claim for H0015? Based on 3K providers billing this code nationally.
Median
$129.75
Average
$227.93
Std Dev
$636.09
Max
$13,333.89
Percentile Distribution (Cost per Claim)
50% of providers bill between $102.96 and $164.93 per claim for this code.
90% bill between $74.62 and $226.82.
Top 1% bill above $2,915.26.
About This Procedure
HCPCS code H0015 (Alcohol and/or drug abuse, intensive outpatient, per hour) was billed by 3K providers across 25.1M claims, totaling $3.81B in Medicaid payments from 2018–2024. This code was used for 3.7M unique beneficiaries.
Fraud Risk Context
Substance abuse treatment codes have seen increased scrutiny due to patient brokering and sober home schemes.
Source: HHS OIG & DOJ Enforcement Actions
Risk Assessment
Billing Statistics
Median Cost/Claim
$129.75
Providers Billing
3K
National Spending
$3.81B
Avg/Median Ratio
1.76×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for H0015
| # | Provider | Total Paid |
|---|---|---|
| 1 | Scioto County Counseling Center, Inc Portsmouth, OH · Counselor, Addiction (Substance Use Disorder) | $104.5M |
| 2 | 1629560230 | $64.1M |
| 3 | 1598242281 | $37.7M |
| 4 | 1215428016 | $34.1M |
| 5 | Four Winds Behavioral Health Inc. Rio Rancho, NM · Substance Abuse Rehabilitation Facility | $29.5M |
| 6 | 1225097231 | $29.0M |
| 7 | Los Angeles County Department Of Public Health Alhambra, CA · Public Health or Welfare | $28.8M |
| 8 | New Freedom Ops Llc Phoenix, AZ · Community/Behavioral Health | $27.8M |
| 9 | Addiction Recovery Care Llc Louisa, KY · Community Based Residential Treatment Facility, Mental Illness | $26.7M |
| 10 | Rehema Behavioral Health Clinic Llc Phoenix, AZ · Clinical Nurse Specialist, Psych/Mental Health | $26.4M |
| 11 | Happy House Behavioral Valley Phoenix, AZ · Clinic/Center, Mental Health (Including Community Mental Health Center) | $25.5M |
| 12 | Aspire Community Services Glendale, AZ · Counselor, Mental Health | $24.4M |
| 13 | 1730594219 | $23.1M |
| 14 | 1104949973 | $21.6M |
| 15 | 1225670813 | $20.9M |
| 16 | 1225260888 | $20.9M |
| 17 | Darrins Place Inc Espanola, NM · Substance Abuse Rehabilitation Facility | $20.5M |
| 18 | 1700290301 | $20.1M |
| 19 | Sycamore Integrated Health Llc Mesa, AZ · Clinic/Center | $20.1M |
| 20 | 1275589178 | $19.3M |
Showing top 20 of 3K providers billing this code