Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#388 of 11K

H2030

Mental health clubhouse services, per 15 minutes

Mental health clubhouse services, per 15 minutes is the #388 most-billed Medicaid procedure code, with $281.1M in payments across 3.6M claims from 2018–2024. The national median cost per claim is $73.58. Costs vary widely — the 90th percentile is $164.23 per claim, 2.2× the median.

Total Paid

$281.1M

0.03% of all spending

Total Claims

3.6M

Providers

150

Avg Cost/Claim

$79

National Cost Distribution

How much do providers bill per claim for H2030? Based on 144 providers billing this code nationally.

Median

$73.58

Average

$87.67

Std Dev

$54.33

Max

$309.46

Percentile Distribution (Cost per Claim)

p10
$38.61
p25
$55.92
Median
$73.58
p75
$101.72
p90
$164.23
p95
$207.44
p99
$248.87

50% of providers bill between $55.92 and $101.72 per claim for this code.

90% bill between $38.61 and $164.23.

Top 1% bill above $248.87.

About This Procedure

HCPCS code H2030 (Mental health clubhouse services, per 15 minutes) was billed by 150 providers across 3.6M claims, totaling $281.1M in Medicaid payments from 2018–2024. This code was used for 325K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$73.58

Providers Billing

144

National Spending

$281.1M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for H2030

#ProviderTotal Paid
1Kennebec Valley Mental Health Center

Waterville, ME · Clinic/Center Mental Health (Including Community Mental Health Center)

$28.0M
21154433233$14.3M
31700894730$10.3M
41063428761$8.6M
51265426084$8.1M
6Cns Healthcare

Novi, MI · Psychiatry & Neurology Psychiatry

$7.9M
7Macomb County Community Mental Health

Clinton Twp, MI · Clinic/Center Mental Health (Including Community Mental Health Center)

$7.2M
81669451944$7.2M
9Community Mental Health For Central Michigan

Mt Pleasant, MI · Psychiatry & Neurology Psychiatry

$6.7M
101043534191$6.6M
111932422078$6.5M
121982610572$6.3M
131073626511$6.3M
141275585929$6.2M
151972613628$5.9M
16Community Mental Health Authority Of Clinton Eaton Ingham Counties

Lansing, MI · Clinic/Center Mental Health (Including Community Mental Health Center)

$5.7M
171710074448$5.6M
18Northern Lakes Community Mental Health Authority

Traverse City, MI · Occupational Therapist

$5.4M
191548358245$5.1M
20County Of Muskegon

Muskegon, MI · Clinic/Center, Mental Health (Including Community Mental Health Center)

$4.8M

Showing top 20 of 150 providers billing this code