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

#1395 of 11K

M0118

HCPCS Procedure Code

HCPCS code M0118 is the #1,395 most-billed Medicaid procedure code, with $24.7M in payments across 694K claims from 2018–2024. The national median cost per claim is $38.00.

Total Paid

$24.7M

0.00% of all spending

Total Claims

694K

Providers

103

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for M0118? Based on 103 providers billing this code nationally.

Median

$38.00

Average

$37.80

Std Dev

$3.32

Max

$46.44

Percentile Distribution (Cost per Claim)

p10
$34.25
p25
$36.57
Median
$38.00
p75
$39.65
p90
$40.77
p95
$41.14
p99
$46.38

50% of providers bill between $36.57 and $39.65 per claim for this code.

90% bill between $34.25 and $40.77.

Top 1% bill above $46.38.

About This Procedure

HCPCS code M0118 was billed by 103 providers across 694K claims, totaling $24.7M in Medicaid payments from 2018–2024. This code was used for 34K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.00

Providers Billing

103

National Spending

$24.7M

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0118

#ProviderTotal Paid
1Daybreak Community Services Texas Llc

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

$2.5M
2Berry Family Services

Rowlett, TX · Case Management

$1.1M
3D&s Residential Services, Lp

Austin, TX · Intermediate Care Facility, Intellectual Disabilities

$908K
4Rock House Support Services, Inc.

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

$759K
51871794933$619K
6St. Giles Living Centers, Inc.

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

$591K
71427259241$584K
8Lifetime Living Inc.

San Antonio, TX · Case Management

$472K
91972700094$456K
10Wellness Healthcare Solutions Inc.

Desoto, TX · Day Training, Developmentally Disabled Services

$439K
11Kenmar Residential Hcs Services Inc.

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

$435K
12Advantage Behavioral Services, Inc.

San Antonio, TX · Case Management

$412K
131598974057$399K
141205037900$386K
151144658428$376K
161801838461$346K
171710014618$319K
181295988186$316K
191013261015$315K
201811039225$302K

Showing top 20 of 103 providers billing this code