H0018
Behavioral health; short-term residential, per diem
Behavioral health; short-term residential, per diem is the #46 most-billed Medicaid procedure code, with $4.40B in payments across 10.7M claims from 2018–2024. The national median cost per claim is $467.51. Costs vary widely — the 90th percentile is $2,926.44 per claim, 6.3× the median.
Total Paid
$4.40B
0.40% of all spending
Total Claims
10.7M
Providers
1K
Avg Cost/Claim
$412
National Cost Distribution
How much do providers bill per claim for H0018? Based on 1K providers billing this code nationally.
Median
$467.51
Average
$1,143.01
Std Dev
$1,461.61
Max
$15,482.14
Percentile Distribution (Cost per Claim)
50% of providers bill between $210.90 and $1,623.09 per claim for this code.
90% bill between $149.02 and $2,926.44.
Top 1% bill above $6,270.95.
About This Procedure
HCPCS code H0018 (Behavioral health; short-term residential, per diem) was billed by 1K providers across 10.7M claims, totaling $4.40B in Medicaid payments from 2018–2024. This code was used for 1.3M 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
$467.51
Providers Billing
1K
National Spending
$4.40B
Avg/Median Ratio
2.44×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for H0018
| # | Provider | Total Paid |
|---|---|---|
| 1 | Ma-department Of Social Services-rehab Boston, MA · Public Health or Welfare | $490.7M |
| 2 | State Of Missouri Jefferson City, MO · Rehabilitation Counselor | $134.5M |
| 3 | Orion Homes Llc Phoenix, AZ · Community Based Residential Treatment Facility Mental Illness | $83.8M |
| 4 | County Of San Bernardino San Bernardino, CA · Clinic/Center Rehabilitation Substance Use Disorder | $58.2M |
| 5 | Community Bridges Inc. Mesa, AZ · Community/Behavioral Health | $54.9M |
| 6 | 1033143706 | $54.8M |
| 7 | County Of Santa Clara San Jose, CA · Community/Behavioral Health | $51.4M |
| 8 | State Of Oklahoma Dept. Of Human Services Oklahoma City, OK · Community/Behavioral Health | $50.2M |
| 9 | Los Angeles County Department Of Mental Health Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center) | $47.2M |
| 10 | Pyramid Healthcare Belleville, PA · Substance Abuse Rehabilitation Facility | $44.5M |
| 11 | White Deer Run Llc Allenwood, PA · Community/Behavioral Health | $41.6M |
| 12 | 1750363305 | $39.4M |
| 13 | 1477643104 | $39.3M |
| 14 | 1376550566 | $38.2M |
| 15 | Ma Department Of Youth Services Boston, MA · Public Health or Welfare | $37.0M |
| 16 | 1154474104 | $36.7M |
| 17 | County Of Sacramento Sacramento, CA · Clinic/Center Adult Mental Health | $34.3M |
| 18 | 1073648374 | $33.5M |
| 19 | County Of Orange Santa Ana, CA · Clinic/Center Mental Health (Including Community Mental Health Center) | $33.4M |
| 20 | 1306243084 | $33.2M |
Showing top 20 of 1K providers billing this code