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#110 of 11K

H0035

Mental health partial hospitalization, treatment, per hour

Mental health partial hospitalization, treatment, per hour is the #110 most-billed Medicaid procedure code, with $1.81B in payments across 14.1M claims from 2018–2024. The national median cost per claim is $148.53. Costs vary widely — the 90th percentile is $332.64 per claim, 2.2× the median.

Total Paid

$1.81B

0.17% of all spending

Total Claims

14.1M

Providers

794

Avg Cost/Claim

$128

National Cost Distribution

How much do providers bill per claim for H0035? Based on 782 providers billing this code nationally.

Median

$148.53

Average

$186.55

Std Dev

$191.82

Max

$3,541.75

Percentile Distribution (Cost per Claim)

p10
$71.79
p25
$88.56
Median
$148.53
p75
$225.55
p90
$332.64
p95
$437.58
p99
$872.87

50% of providers bill between $88.56 and $225.55 per claim for this code.

90% bill between $71.79 and $332.64.

Top 1% bill above $872.87.

About This Procedure

HCPCS code H0035 (Mental health partial hospitalization, treatment, per hour) was billed by 794 providers across 14.1M claims, totaling $1.81B in Medicaid payments from 2018–2024. This code was used for 1.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$148.53

Providers Billing

782

National Spending

$1.81B

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for H0035

#ProviderTotal Paid
11942217054$69.9M
21891871489$44.3M
31518009588$33.2M
41093891335$31.7M
5Addiction Recovery Care Llc

Louisa, KY · Community Based Residential Treatment Facility, Mental Illness

$27.5M
6Virtua - West Jersey Health System Inc.

Voorhees, NJ · General Acute Care Hospital

$26.8M
71568512010$22.3M
81568638559$21.8M
9Jersey City Medical Center

Jersey City, NJ · General Acute Care Hospital

$21.0M
101447614698$18.6M
11Alabama Department Of Mental Health And Mental Retardation

Montgomery, AL · Community/Behavioral Health

$18.2M
12Health Connect America Inc

Franklin, TN · Community/Behavioral Health

$18.1M
131811053101$18.0M
141871658757$16.1M
151619289634$16.1M
16Moonlight Mountain Recovery, Inc

Pocatello, ID · Clinic/Center, Mental Health (Including Community Mental Health Center)

$16.0M
171598992182$15.1M
181609995141$14.5M
191215182928$14.0M
20Inspira Medical Centers Inc.

Vineland, NJ · General Acute Care Hospital

$12.7M

Showing top 20 of 794 providers billing this code