S0280
Medical home program, comprehensive care management
Medical home program, comprehensive care management is the #182 most-billed Medicaid procedure code, with $925.8M in payments across 6.6M claims from 2018–2024. The national median cost per claim is $48.38. Costs vary widely — the 90th percentile is $246.30 per claim, 5.1× the median.
Total Paid
$925.8M
0.08% of all spending
Total Claims
6.6M
Providers
414
Avg Cost/Claim
$141
National Cost Distribution
How much do providers bill per claim for S0280? Based on 393 providers billing this code nationally.
Median
$48.38
Average
$104.21
Std Dev
$90.46
Max
$362.28
Percentile Distribution (Cost per Claim)
50% of providers bill between $39.18 and $157.83 per claim for this code.
90% bill between $26.39 and $246.30.
Top 1% bill above $328.21.
About This Procedure
HCPCS code S0280 (Medical home program, comprehensive care management) was billed by 414 providers across 6.6M claims, totaling $925.8M in Medicaid payments from 2018–2024. This code was used for 5.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$48.38
Providers Billing
393
National Spending
$925.8M
Avg/Median Ratio
2.15×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S0280
| # | Provider | Total Paid |
|---|---|---|
| 1 | Mental Health Cooperative Inc Nashville, TN · Clinic/Center Mental Health (Including Community Mental Health Center) | $243.9M |
| 2 | Volunteer Behavioral Health Care System Murfreesboro, TN · Counselor | $118.1M |
| 3 | Health Connect America Inc Franklin, TN · Community/Behavioral Health | $83.2M |
| 4 | Helen Ross Mcnabb Center Knoxville, TN · Clinic/Center Mental Health (Including Community Mental Health Center) | $80.7M |
| 5 | Centerstone Of Tennessee Inc. Nashville, TN · Clinic/Center Mental Health (Including Community Mental Health Center) | $67.9M |
| 6 | Omni Community Health Inc. Knoxville, TN · Community/Behavioral Health | $49.4M |
| 7 | 1720147408 | $41.8M |
| 8 | Alliance Healthcare Services Memphis, TN · Community/Behavioral Health | $23.7M |
| 9 | 1831397645 | $21.5M |
| 10 | 1326116476 | $16.6M |
| 11 | 1457351215 | $16.6M |
| 12 | 1497721609 | $16.6M |
| 13 | 1255442794 | $12.8M |
| 14 | 1134128820 | $10.3M |
| 15 | 1437125416 | $9.0M |
| 16 | 1396739165 | $8.8M |
| 17 | 1184659229 | $8.1M |
| 18 | Generations Health Association Inc. Morrison, TN · Clinic/Center Mental Health (Including Community Mental Health Center) | $7.7M |
| 19 | Carey Counseling Center Inc. Paris, TN · Counselor Mental Health | $6.9M |
| 20 | Cns Healthcare Novi, MI · Psychiatry & Neurology Psychiatry | $4.2M |
Showing top 20 of 414 providers billing this code