#2976 of 11K

M0372

HCPCS Procedure Code

HCPCS code M0372 is the #2,976 most-billed Medicaid procedure code, with $2.9M in payments across 233K claims from 2018–2024. The national median cost per claim is $13.55. Costs vary widely — the 90th percentile is $28.95 per claim, 2.1× the median.

Total Paid

$2.9M

0.00% of all spending

Total Claims

233K

Providers

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for M0372? Based on 33 providers billing this code nationally.

Median

$13.55

Average

$15.16

Std Dev

$7.93

Max

$36.46

Percentile Distribution (Cost per Claim)

p10

$7.43

p25

$9.82

Median

$13.55

p75

$16.28

p90

$28.95

p95

$32.77

p99

$36.18

50% of providers bill between $9.82 and $16.28 per claim for this code.

90% bill between $7.43 and $28.95.

Top 1% bill above $36.18.

About This Procedure

HCPCS code M0372 was billed by 33 providers across 233K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 19K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.55

Providers Billing

National Spending

$2.9M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0372

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Volunteers Of America Texas Inc. Euless, TX · Intermediate Care Facility Intellectual Disabilities	$327K	$30.70	2.3× median	Top 10%
2	1992836936	$244K	$11.34	0.8× median	Below Median
3	1952526576	$243K	$8.74	0.6× median	Below Median
4	Texana Center Rosenberg, TX · Counselor, Mental Health	$235K	$11.27	0.8× median	Below Median
5	Wellness Healthcare Solutions Inc. Desoto, TX · Day Training, Developmentally Disabled Services	$234K	$35.58	2.6× median	Top 10%
6	1902976285	$183K	$9.82	0.7× median	Below Median
7	Berry Family Services Rowlett, TX · Case Management	$159K	$30.89	2.3× median	Top 10%
8	1841304201	$148K	$7.28	0.5× median	Below Median
9	Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities	$131K	$14.92	1.1× median	Above Median
10	1134244106	$117K	$7.13	0.5× median	Below Median
11	1760555619	$109K	$8.75	0.6× median	Below Median
12	1902812373	$107K	$6.05	0.4× median	Below Median
13	1710014618	$95K	$21.92	1.6× median	Above 75th
14	1629185566	$83K	$16.62	1.2× median	Above 75th
15	1023161890	$75K	$7.29	0.5× median	Below Median
16	1063614022	$61K	$14.79	1.1× median	Above Median
17	1417160532	$39K	$15.11	1.1× median	Above Median
18	1801940929	$35K	$13.20	1.0× median	Below Median
19	1417011396	$31K	$21.91	1.6× median	Above 75th
20	1578698395	$30K	$8.81	0.7× median	Below Median

Showing top 20 of 33 providers billing this code

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