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#2385 of 11K

M0209

HCPCS Procedure Code

HCPCS code M0209 is the #2,385 most-billed Medicaid procedure code, with $6.2M in payments across 33K claims from 2018–2024. The national median cost per claim is $189.12.

Total Paid

$6.2M

0.00% of all spending

Total Claims

33K

Providers

11

Avg Cost/Claim

$187

National Cost Distribution

How much do providers bill per claim for M0209? Based on 11 providers billing this code nationally.

Median

$189.12

Average

$185.20

Std Dev

$18.40

Max

$210.08

Percentile Distribution (Cost per Claim)

p10
$154.79
p25
$177.76
Median
$189.12
p75
$192.37
p90
$210.08
p95
$210.08
p99
$210.08

50% of providers bill between $177.76 and $192.37 per claim for this code.

90% bill between $154.79 and $210.08.

Top 1% bill above $210.08.

About This Procedure

HCPCS code M0209 was billed by 11 providers across 33K claims, totaling $6.2M in Medicaid payments from 2018–2024. This code was used for 33K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$189.12

Providers Billing

11

National Spending

$6.2M

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0209

#ProviderTotal Paid
1Consumer Directed Services In Texas Inc.

San Antonio, TX · Supports Brokerage

$1.6M
2Segnik Group Inc

Houston, TX · Supports Brokerage

$1.6M
3Alamo Consumer Direct, Llc

Austin, TX · Supports Brokerage

$1.3M
4Acumen Fiscal Agent Llc

Mesa, AZ · Community/Behavioral Health

$674K
5Eak Good Neighbor Properties

Mount Vernon, TX · Day Training, Developmentally Disabled Services

$474K
61124158175$407K
71578631024$69K
81497049779$47K
91720149982$43K
101932486925$17K
11Imagine Enterprises

Seabrook, TX · Supports Brokerage

$16K

Showing top 11 of 11 providers billing this code