H0016
Alcohol or drug abuse services, prenatal
Alcohol or drug abuse services, prenatal is the #506 most-billed Medicaid procedure code, with $178.3M in payments across 1.2M claims from 2018–2024. The national median cost per claim is $182.66.
Total Paid
$178.3M
0.02% of all spending
Total Claims
1.2M
Providers
337
Avg Cost/Claim
$152
National Cost Distribution
How much do providers bill per claim for H0016? Based on 316 providers billing this code nationally.
Median
$182.66
Average
$174.03
Std Dev
$71.53
Max
$421.37
Percentile Distribution (Cost per Claim)
50% of providers bill between $128.55 and $226.03 per claim for this code.
90% bill between $79.12 and $247.48.
Top 1% bill above $310.76.
About This Procedure
HCPCS code H0016 (Alcohol or drug abuse services, prenatal) was billed by 337 providers across 1.2M claims, totaling $178.3M in Medicaid payments from 2018–2024. This code was used for 677K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$182.66
Providers Billing
316
National Spending
$178.3M
Avg/Median Ratio
0.95×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for H0016
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1679926745 | $21.2M |
| 2 | Ideal Option, Pllc Pasco, WA · Preventive Medicine, Addiction Medicine | $12.3M |
| 3 | 1801345285 | $12.0M |
| 4 | 1538628904 | $9.4M |
| 5 | 1487185153 | $6.6M |
| 6 | 1184150229 | $6.1M |
| 7 | 1346736758 | $5.6M |
| 8 | 1013483486 | $5.6M |
| 9 | 1598256117 | $4.7M |
| 10 | 1205360153 | $4.6M |
| 11 | 1447611165 | $3.3M |
| 12 | 1689134231 | $3.2M |
| 13 | 1891246658 | $3.1M |
| 14 | 1770080632 | $3.0M |
| 15 | 1770011652 | $2.6M |
| 16 | 1629597653 | $2.6M |
| 17 | 1477186336 | $2.6M |
| 18 | 1083222640 | $2.4M |
| 19 | 1689892473 | $2.3M |
| 20 | 1356792816 | $2.3M |
Showing top 20 of 337 providers billing this code