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#2089 of 11K

M0113

HCPCS Procedure Code

HCPCS code M0113 is the #2,089 most-billed Medicaid procedure code, with $9.2M in payments across 23K claims from 2018–2024. The national median cost per claim is $397.30.

Total Paid

$9.2M

0.00% of all spending

Total Claims

23K

Providers

128

Avg Cost/Claim

$399

National Cost Distribution

How much do providers bill per claim for M0113? Based on 128 providers billing this code nationally.

Median

$397.30

Average

$436.76

Std Dev

$162.42

Max

$1,084.82

Percentile Distribution (Cost per Claim)

p10
$286.06
p25
$322.90
Median
$397.30
p75
$509.77
p90
$631.07
p95
$724.44
p99
$1,007.19

50% of providers bill between $322.90 and $509.77 per claim for this code.

90% bill between $286.06 and $631.07.

Top 1% bill above $1,007.19.

About This Procedure

HCPCS code M0113 was billed by 128 providers across 23K claims, totaling $9.2M in Medicaid payments from 2018–2024. This code was used for 21K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$397.30

Providers Billing

128

National Spending

$9.2M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0113

#ProviderTotal Paid
1Daybreak Community Services Texas Llc

Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities

$1.1M
2Berry Family Services

Rowlett, TX · Case Management

$511K
3D&s Residential Services, Lp

Austin, TX · Intermediate Care Facility, Intellectual Disabilities

$465K
4Lifetime Living Inc.

San Antonio, TX · Case Management

$350K
5Rock House Support Services, Inc.

Stephenville, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$290K
61710014618$212K
7Texana Center

Rosenberg, TX · Counselor, Mental Health

$192K
8Advantage Behavioral Services, Inc.

San Antonio, TX · Case Management

$188K
91871794933$186K
10St. Giles Living Centers, Inc.

Fort Worth, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$178K
111154497444$174K
121396954855$171K
131295944759$170K
14Kenmar Residential Hcs Services Inc.

Round Rock, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$158K
151598974057$151K
161790860666$146K
171326252214$140K
18Wellness Healthcare Solutions Inc.

Desoto, TX · Day Training, Developmentally Disabled Services

$140K
191427259241$138K
201891823381$131K

Showing top 20 of 128 providers billing this code