M0167
HCPCS Procedure Code
HCPCS code M0167 is the #1,144 most-billed Medicaid procedure code, with $37.2M in payments across 249K claims from 2018–2024. The national median cost per claim is $158.84.
Total Paid
$37.2M
0.00% of all spending
Total Claims
249K
Providers
36
Avg Cost/Claim
$150
National Cost Distribution
How much do providers bill per claim for M0167? Based on 36 providers billing this code nationally.
Median
$158.84
Average
$156.54
Std Dev
$18.56
Max
$189.46
Percentile Distribution (Cost per Claim)
50% of providers bill between $152.23 and $161.91 per claim for this code.
90% bill between $151.61 and $162.12.
Top 1% bill above $189.46.
About This Procedure
HCPCS code M0167 was billed by 36 providers across 249K claims, totaling $37.2M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$158.84
Providers Billing
36
National Spending
$37.2M
Avg/Median Ratio
0.99×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for M0167
| # | Provider | Total Paid |
|---|---|---|
| 1 | Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $5.7M |
| 2 | Rock House Support Services, Inc. Stephenville, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $3.2M |
| 3 | 1235431453 | $1.9M |
| 4 | 1871794933 | $1.7M |
| 5 | 1891971297 | $1.6M |
| 6 | 1033272471 | $1.5M |
| 7 | 1447313879 | $1.5M |
| 8 | 1689756439 | $1.4M |
| 9 | 1134322076 | $1.4M |
| 10 | 1700926987 | $1.3M |
| 11 | St. Giles Living Centers, Inc. Fort Worth, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $1.3M |
| 12 | 1699718528 | $1.1M |
| 13 | 1508911348 | $1.1M |
| 14 | 1205037066 | $1.1M |
| 15 | 1396954855 | $996K |
| 16 | 1033313168 | $968K |
| 17 | D&s Residential Services, Lp Austin, TX · Intermediate Care Facility, Intellectual Disabilities | $923K |
| 18 | 1427259241 | $878K |
| 19 | 1891003604 | $865K |
| 20 | 1891823381 | $847K |
Showing top 20 of 36 providers billing this code