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#5281 of 11K

M0539

HCPCS Procedure Code

HCPCS code M0539 is the #5,281 most-billed Medicaid procedure code, with $242K in payments across 38K claims from 2018–2024. The national median cost per claim is $7.60.

Total Paid

$242K

0.00% of all spending

Total Claims

38K

Providers

6

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for M0539? Based on 6 providers billing this code nationally.

Median

$7.60

Average

$7.96

Std Dev

$4.88

Max

$15.08

Percentile Distribution (Cost per Claim)

p10
$3.01
p25
$4.35
Median
$7.60
p75
$10.91
p90
$13.27
p95
$14.17
p99
$14.90

50% of providers bill between $4.35 and $10.91 per claim for this code.

90% bill between $3.01 and $13.27.

Top 1% bill above $14.90.

About This Procedure

HCPCS code M0539 was billed by 6 providers across 38K claims, totaling $242K in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.60

Providers Billing

6

National Spending

$242K

Avg/Median Ratio

1.05×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0539

#ProviderTotal Paid
1Consumer Directed Services In Texas Inc.

San Antonio, TX · Supports Brokerage

$100K
2Acumen Fiscal Agent Llc

Mesa, AZ · Community/Behavioral Health

$46K
3Eak Good Neighbor Properties

Mount Vernon, TX · Day Training, Developmentally Disabled Services

$43K
4Alamo Consumer Direct, Llc

Austin, TX · Supports Brokerage

$29K
5In-home Attendant Services Ltd.

Houston, TX · Technician Personal Care Attendant

$20K
6Imagine Enterprises

Seabrook, TX · Supports Brokerage

$3K

Showing top 6 of 6 providers billing this code

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