M0166
HCPCS Procedure Code
HCPCS code M0166 is the #1,525 most-billed Medicaid procedure code, with $20.1M in payments across 134K claims from 2018–2024. The national median cost per claim is $151.35.
Total Paid
$20.1M
0.00% of all spending
Total Claims
134K
Providers
17
Avg Cost/Claim
$150
National Cost Distribution
How much do providers bill per claim for M0166? Based on 17 providers billing this code nationally.
Median
$151.35
Average
$149.06
Std Dev
$3.80
Max
$152.89
Percentile Distribution (Cost per Claim)
50% of providers bill between $145.89 and $152.31 per claim for this code.
90% bill between $142.84 and $152.41.
Top 1% bill above $152.82.
About This Procedure
HCPCS code M0166 was billed by 17 providers across 134K claims, totaling $20.1M in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$151.35
Providers Billing
17
National Spending
$20.1M
Avg/Median Ratio
0.98×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for M0166
| # | Provider | Total Paid |
|---|---|---|
| 1 | Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $4.9M |
| 2 | D&s Residential Services, Lp Austin, TX · Intermediate Care Facility, Intellectual Disabilities | $1.8M |
| 3 | 1548462914 | $1.5M |
| 4 | 1699718528 | $1.5M |
| 5 | St. Giles Living Centers, Inc. Fort Worth, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $1.4M |
| 6 | Texana Center Rosenberg, TX · Counselor, Mental Health | $1.3M |
| 7 | 1992836936 | $925K |
| 8 | 1235431453 | $921K |
| 9 | 1871794933 | $859K |
| 10 | 1760555619 | $858K |
| 11 | 1326252214 | $775K |
| 12 | 1447313879 | $773K |
| 13 | 1598974057 | $738K |
| 14 | 1578698395 | $731K |
| 15 | 1801962295 | $587K |
| 16 | 1184729675 | $398K |
| 17 | 1063614022 | $132K |
Showing top 17 of 17 providers billing this code