T1001
Nursing assessment/evaluation, per visit
Nursing assessment/evaluation, per visit is the #286 most-billed Medicaid procedure code, with $496.7M in payments across 9.5M claims from 2018–2024. The national median cost per claim is $49.05. Costs vary widely — the 90th percentile is $140.66 per claim, 2.9× the median.
Total Paid
$496.7M
0.05% of all spending
Total Claims
9.5M
Providers
2K
Avg Cost/Claim
$53
National Cost Distribution
How much do providers bill per claim for T1001? Based on 2K providers billing this code nationally.
Median
$49.05
Average
$73.13
Std Dev
$86.89
Max
$1,225.43
Percentile Distribution (Cost per Claim)
50% of providers bill between $31.96 and $80.97 per claim for this code.
90% bill between $14.64 and $140.66.
Top 1% bill above $442.57.
About This Procedure
HCPCS code T1001 (Nursing assessment/evaluation, per visit) was billed by 2K providers across 9.5M claims, totaling $496.7M in Medicaid payments from 2018–2024. This code was used for 5.6M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$49.05
Providers Billing
2K
National Spending
$496.7M
Avg/Median Ratio
1.49×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for T1001
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1932227790 | $35.2M |
| 2 | 1770957219 | $13.2M |
| 3 | County Of San Bernardino San Bernardino, CA · Clinic/Center Rehabilitation Substance Use Disorder | $11.3M |
| 4 | 1992859888 | $8.7M |
| 5 | 1194975326 | $7.9M |
| 6 | Phoenix Home Care, Llc Springfield, MO · Chore Provider | $7.7M |
| 7 | 1316097157 | $7.7M |
| 8 | Wasatch Behavioral Health Special Service District Provo, UT · Community/Behavioral Health | $7.6M |
| 9 | 1235294380 | $7.4M |
| 10 | Valley Behavioral Health Incorporated Salt Lake City, UT · Psychiatry & Neurology Psychiatry | $6.4M |
| 11 | 1891880852 | $6.3M |
| 12 | 1194840041 | $5.7M |
| 13 | 1821294521 | $5.6M |
| 14 | Los Angeles Unified School District Los Angeles, CA · Social Worker School | $5.5M |
| 15 | 1679032379 | $5.3M |
| 16 | 1285736553 | $4.9M |
| 17 | 1538136700 | $4.2M |
| 18 | 1285677930 | $4.1M |
| 19 | Southern Home Care Services Inc. Saint Louis, MO · In Home Supportive Care | $3.8M |
| 20 | 1528059805 | $3.7M |
Showing top 20 of 2K providers billing this code