T1016
Case management, each 15 min
Case management, each 15 min is the #36 most-billed Medicaid procedure code, with $5.21B in payments across 98.3M claims from 2018–2024. The national median cost per claim is $49.62. Costs vary widely — the 90th percentile is $197.49 per claim, 4.0× the median.
Total Paid
$5.21B
0.48% of all spending
Total Claims
98.3M
Providers
5K
Avg Cost/Claim
$53
National Cost Distribution
How much do providers bill per claim for T1016? Based on 4K providers billing this code nationally.
Median
$49.62
Average
$105.95
Std Dev
$264.41
Max
$6,667.91
Percentile Distribution (Cost per Claim)
50% of providers bill between $26.18 and $91.48 per claim for this code.
90% bill between $12.00 and $197.49.
Top 1% bill above $1,101.18.
About This Procedure
HCPCS code T1016 (Case management, each 15 min) was billed by 5K providers across 98.3M claims, totaling $5.21B in Medicaid payments from 2018–2024. This code was used for 33.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$49.62
Providers Billing
4K
National Spending
$5.21B
Avg/Median Ratio
2.14×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for T1016
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Mental Health Center Of Greater Manchester Manchester, NH · Clinic/Center Mental Health (Including Community Mental Health Center) | $69.2M |
| 2 | 1063568574 | $57.7M |
| 3 | Riverbend Community Mental Health Inc. Concord, NH · Clinic/Center Mental Health (Including Community Mental Health Center) | $45.6M |
| 4 | Macomb Oakland Regional Center Inc. Auburn Hills, MI · Community/Behavioral Health | $44.0M |
| 5 | 1124073432 | $42.3M |
| 6 | A Better You Wellness Center, Llc Phoenix, AZ · Community/Behavioral Health | $41.7M |
| 7 | Community Involvement Programs Minneapolis, MN · Day Training Developmentally Disabled Services | $41.5M |
| 8 | 1013092857 | $40.5M |
| 9 | 1326264359 | $40.0M |
| 10 | 1770588444 | $38.0M |
| 11 | Codac Health Recovery And Wellness Tucson, AZ · Community/Behavioral Health | $37.2M |
| 12 | La Frontera Center Inc. Tucson, AZ · Clinic/Center Mental Health (Including Community Mental Health Center) | $35.9M |
| 13 | Partners In Recovery Llc Mesa, AZ · Community/Behavioral Health | $35.4M |
| 14 | 1669897385 | $35.4M |
| 15 | 1003914466 | $35.0M |
| 16 | 1447652227 | $35.0M |
| 17 | New Life Wellness Center Llc Phoenix, AZ · Public Health or Welfare | $31.9M |
| 18 | 1740406669 | $30.7M |
| 19 | A.w. Holdings Llc Fort Wayne, IN · Psychologist Intellectual & Developmental Disabilities | $28.7M |
| 20 | 1760864805 | $28.0M |
Showing top 20 of 5K providers billing this code