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#118 of 11K

H0039

Assertive community treatment, per diem

Assertive community treatment, per diem is the #118 most-billed Medicaid procedure code, with $1.70B in payments across 13.4M claims from 2018–2024. The national median cost per claim is $132.62. Costs vary widely — the 90th percentile is $770.25 per claim, 5.8× the median.

Total Paid

$1.70B

0.16% of all spending

Total Claims

13.4M

Providers

499

Avg Cost/Claim

$127

National Cost Distribution

How much do providers bill per claim for H0039? Based on 462 providers billing this code nationally.

Median

$132.62

Average

$258.25

Std Dev

$400.86

Max

$2,276.14

Percentile Distribution (Cost per Claim)

p10
$25.01
p25
$66.99
Median
$132.62
p75
$217.44
p90
$770.25
p95
$1,024.04
p99
$1,945.21

50% of providers bill between $66.99 and $217.44 per claim for this code.

90% bill between $25.01 and $770.25.

Top 1% bill above $1,945.21.

About This Procedure

HCPCS code H0039 (Assertive community treatment, per diem) was billed by 499 providers across 13.4M claims, totaling $1.70B in Medicaid payments from 2018–2024. This code was used for 1.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$132.62

Providers Billing

462

National Spending

$1.70B

Avg/Median Ratio

1.95×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for H0039

#ProviderTotal Paid
11497819510$50.0M
2Trilogy, Inc.

Chicago, IL · Clinic/Center, Community Health

$49.1M
31407872575$39.9M
41033484019$37.6M
5Mbi Health Services Llc

Washington, DC · Case Management

$34.4M
61255606224$32.3M
71700156866$30.1M
81811265242$28.1M
91013077551$27.5M
10New Vitae Inc.

Quakertown, PA · Community/Behavioral Health

$24.5M
111023382033$24.0M
121700218260$23.7M
131922311679$22.0M
14Mercy Life Center Corporation

Pittsburgh, PA · Public Health or Welfare

$21.1M
151740319854$20.8M
161992079909$20.4M
171063528560$20.2M
18Community Mental Health For Central Michigan

Mt Pleasant, MI · Psychiatry & Neurology Psychiatry

$18.4M
191982962353$18.2M
201083807929$18.2M

Showing top 20 of 499 providers billing this code