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#1286 of 11K

M0361

HCPCS Procedure Code

HCPCS code M0361 is the #1,286 most-billed Medicaid procedure code, with $29.2M in payments across 160K claims from 2018–2024. The national median cost per claim is $151.88. Costs vary widely — the 90th percentile is $308.04 per claim, 2.0× the median.

Total Paid

$29.2M

0.00% of all spending

Total Claims

160K

Providers

9

Avg Cost/Claim

$182

National Cost Distribution

How much do providers bill per claim for M0361? Based on 9 providers billing this code nationally.

Median

$151.88

Average

$229.07

Std Dev

$234.81

Max

$854.12

Percentile Distribution (Cost per Claim)

p10
$131.61
p25
$146.46
Median
$151.88
p75
$166.09
p90
$308.04
p95
$581.08
p99
$799.51

50% of providers bill between $146.46 and $166.09 per claim for this code.

90% bill between $131.61 and $308.04.

Top 1% bill above $799.51.

About This Procedure

HCPCS code M0361 was billed by 9 providers across 160K claims, totaling $29.2M in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$151.88

Providers Billing

9

National Spending

$29.2M

Avg/Median Ratio

1.51×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for M0361

#ProviderTotal Paid
1Segnik Group Inc

Houston, TX · Supports Brokerage

$7.8M
2Consumer Directed Services In Texas Inc.

San Antonio, TX · Supports Brokerage

$6.8M
3Alamo Consumer Direct, Llc

Austin, TX · Supports Brokerage

$5.4M
4Acumen Fiscal Agent Llc

Mesa, AZ · Community/Behavioral Health

$3.4M
5Eak Good Neighbor Properties

Mount Vernon, TX · Day Training, Developmentally Disabled Services

$2.0M
61124158175$1.6M
71578631024$1.1M
81720149982$911K
91497049779$184K

Showing top 9 of 9 providers billing this code