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#96 of 11K

H0046

Mental health services, not otherwise specified

Mental health services, not otherwise specified is the #96 most-billed Medicaid procedure code, with $2.05B in payments across 18.7M claims from 2018–2024. The national median cost per claim is $85.02. Costs vary widely — the 90th percentile is $308.69 per claim, 3.6× the median.

Total Paid

$2.05B

0.19% of all spending

Total Claims

18.7M

Providers

2K

Avg Cost/Claim

$110

National Cost Distribution

How much do providers bill per claim for H0046? Based on 2K providers billing this code nationally.

Median

$85.02

Average

$149.18

Std Dev

$370.01

Max

$8,830.81

Percentile Distribution (Cost per Claim)

p10
$8.05
p25
$19.71
Median
$85.02
p75
$172.81
p90
$308.69
p95
$461.87
p99
$1,089.14

50% of providers bill between $19.71 and $172.81 per claim for this code.

90% bill between $8.05 and $308.69.

Top 1% bill above $1,089.14.

About This Procedure

HCPCS code H0046 (Mental health services, not otherwise specified) was billed by 2K providers across 18.7M claims, totaling $2.05B in Medicaid payments from 2018–2024. This code was used for 4.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$85.02

Providers Billing

2K

National Spending

$2.05B

Avg/Median Ratio

1.75×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for H0046

#ProviderTotal Paid
11497885107$28.2M
21700150166$26.6M
31417072687$25.6M
41760734503$25.0M
51700297447$23.8M
61477963056$22.8M
71770852436$20.2M
81003939364$20.2M
91659652295$19.4M
101366770158$18.5M
111821436338$18.1M
121497279434$17.8M
131902049042$17.6M
141710070545$17.2M
151275565673$17.0M
161902949373$15.6M
171063077451$15.5M
181083876403$14.3M
191194996280$14.2M
201881987048$14.0M

Showing top 20 of 2K providers billing this code