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#2136 of 11K

M0133

HCPCS Procedure Code

HCPCS code M0133 is the #2,136 most-billed Medicaid procedure code, with $8.6M in payments across 103K claims from 2018–2024. The national median cost per claim is $84.70.

Total Paid

$8.6M

0.00% of all spending

Total Claims

103K

Providers

131

Avg Cost/Claim

$83

National Cost Distribution

How much do providers bill per claim for M0133? Based on 131 providers billing this code nationally.

Median

$84.70

Average

$89.11

Std Dev

$41.89

Max

$301.75

Percentile Distribution (Cost per Claim)

p10
$45.36
p25
$65.32
Median
$84.70
p75
$103.26
p90
$133.88
p95
$162.73
p99
$238.10

50% of providers bill between $65.32 and $103.26 per claim for this code.

90% bill between $45.36 and $133.88.

Top 1% bill above $238.10.

About This Procedure

HCPCS code M0133 was billed by 131 providers across 103K claims, totaling $8.6M in Medicaid payments from 2018–2024. This code was used for 38K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$84.70

Providers Billing

131

National Spending

$8.6M

Avg/Median Ratio

1.05×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0133

#ProviderTotal Paid
1Daybreak Community Services Texas Llc

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

$1.0M
2Rock House Support Services, Inc.

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

$440K
3D&s Residential Services, Lp

Austin, TX · Intermediate Care Facility, Intellectual Disabilities

$392K
4Lifetime Living Inc.

San Antonio, TX · Case Management

$271K
51013297704$257K
6Advantage Behavioral Services, Inc.

San Antonio, TX · Case Management

$243K
7St. Giles Living Centers, Inc.

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

$210K
81295254159$196K
91396954855$186K
10Kenmar Residential Hcs Services Inc.

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

$177K
11Berry Family Services

Rowlett, TX · Case Management

$175K
121154782662$168K
131033642137$162K
141710014618$152K
151801962295$140K
161427368349$135K
171922160571$134K
181871704544$133K
191598974057$131K
201891971297$130K

Showing top 20 of 131 providers billing this code