#1760 of 11K

M0299

HCPCS Procedure Code

HCPCS code M0299 is the #1,760 most-billed Medicaid procedure code, with $14.5M in payments across 432K claims from 2018–2024. The national median cost per claim is $34.98. Costs vary widely — the 90th percentile is $73.41 per claim, 2.1× the median.

Total Paid

$14.5M

0.00% of all spending

Total Claims

432K

Providers

305

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for M0299? Based on 305 providers billing this code nationally.

Median

$34.98

Average

$45.31

Std Dev

$38.48

Max

$353.57

Percentile Distribution (Cost per Claim)

p10

$21.14

p25

$26.28

Median

$34.98

p75

$49.37

p90

$73.41

p95

$107.65

p99

$213.97

50% of providers bill between $26.28 and $49.37 per claim for this code.

90% bill between $21.14 and $73.41.

Top 1% bill above $213.97.

About This Procedure

HCPCS code M0299 was billed by 305 providers across 432K claims, totaling $14.5M in Medicaid payments from 2018–2024. This code was used for 155K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.98

Providers Billing

305

National Spending

$14.5M

Avg/Median Ratio

1.30×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0299

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities	$1.5M	$38.82	1.1× median	Above Median
2	D&s Residential Services, Lp Austin, TX · Intermediate Care Facility, Intellectual Disabilities	$650K	$29.23	0.8× median	Below Median
3	1598974057	$477K	$29.36	0.8× median	Below Median
4	St. Giles Living Centers, Inc. Fort Worth, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$338K	$41.24	1.2× median	Above Median
5	1295944759	$332K	$35.73	1.0× median	Above Median
6	1871794933	$317K	$29.41	0.8× median	Below Median
7	1396954855	$284K	$34.85	1.0× median	Below Median
8	Rock House Support Services, Inc. Stephenville, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$263K	$22.24	0.6× median	Below Median
9	Lifetime Living Inc. San Antonio, TX · Case Management	$262K	$73.36	2.1× median	Above 75th
10	1972700094	$230K	$36.40	1.0× median	Above Median
11	1447313879	$217K	$29.99	0.9× median	Below Median
12	1033272471	$205K	$28.10	0.8× median	Below Median
13	1841409307	$204K	$26.56	0.8× median	Below Median
14	1205037066	$197K	$29.96	0.9× median	Below Median
15	1871704544	$187K	$30.88	0.9× median	Below Median
16	1427259241	$179K	$29.83	0.9× median	Below Median
17	Kenmar Residential Hcs Services Inc. Round Rock, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$160K	$34.34	1.0× median	Below Median
18	Texana Center Rosenberg, TX · Counselor, Mental Health	$160K	$23.91	0.7× median	Below Median
19	1891823381	$149K	$28.47	0.8× median	Below Median
20	Advantage Behavioral Services, Inc. San Antonio, TX · Case Management	$147K	$29.83	0.9× median	Below Median

Showing top 20 of 305 providers billing this code

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