M0115
HCPCS Procedure Code
HCPCS code M0115 is the #1,623 most-billed Medicaid procedure code, with $17.5M in payments across 656K claims from 2018–2024. The national median cost per claim is $29.58.
Total Paid
$17.5M
0.00% of all spending
Total Claims
656K
Providers
110
Avg Cost/Claim
$27
National Cost Distribution
How much do providers bill per claim for M0115? Based on 110 providers billing this code nationally.
Median
$29.58
Average
$29.31
Std Dev
$2.99
Max
$36.94
Percentile Distribution (Cost per Claim)
50% of providers bill between $28.45 and $30.95 per claim for this code.
90% bill between $27.43 and $31.56.
Top 1% bill above $33.91.
About This Procedure
HCPCS code M0115 was billed by 110 providers across 656K claims, totaling $17.5M in Medicaid payments from 2018–2024. This code was used for 36K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$29.58
Providers Billing
110
National Spending
$17.5M
Avg/Median Ratio
0.99×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for M0115
| # | Provider | Total Paid |
|---|---|---|
| 1 | Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $2.1M |
| 2 | D&s Residential Services, Lp Austin, TX · Intermediate Care Facility, Intellectual Disabilities | $665K |
| 3 | Texana Center Rosenberg, TX · Counselor, Mental Health | $663K |
| 4 | St. Giles Living Centers, Inc. Fort Worth, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $532K |
| 5 | Berry Family Services Rowlett, TX · Case Management | $431K |
| 6 | 1598974057 | $419K |
| 7 | 1295944759 | $385K |
| 8 | 1871794933 | $383K |
| 9 | 1326252214 | $367K |
| 10 | 1801962295 | $338K |
| 11 | 1699718528 | $313K |
| 12 | 1548462914 | $299K |
| 13 | 1992836936 | $278K |
| 14 | 1689727133 | $275K |
| 15 | Wellness Healthcare Solutions Inc. Desoto, TX · Day Training, Developmentally Disabled Services | $272K |
| 16 | Rock House Support Services, Inc. Stephenville, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $235K |
| 17 | Advantage Behavioral Services, Inc. San Antonio, TX · Case Management | $223K |
| 18 | 1578698395 | $220K |
| 19 | 1801940929 | $217K |
| 20 | 1396954855 | $208K |
Showing top 20 of 110 providers billing this code