T1018
School-based IEP services, per encounter
School-based IEP services, per encounter is the #83 most-billed Medicaid procedure code, with $2.37B in payments across 32.5M claims from 2018–2024. The national median cost per claim is $39.53. Costs vary widely — the 90th percentile is $92.97 per claim, 2.4× the median.
Total Paid
$2.37B
0.22% of all spending
Total Claims
32.5M
Providers
927
Avg Cost/Claim
$73
National Cost Distribution
How much do providers bill per claim for T1018? Based on 923 providers billing this code nationally.
Median
$39.53
Average
$50.97
Std Dev
$41.71
Max
$436.29
Percentile Distribution (Cost per Claim)
50% of providers bill between $29.05 and $61.98 per claim for this code.
90% bill between $20.13 and $92.97.
Top 1% bill above $253.32.
About This Procedure
HCPCS code T1018 (School-based IEP services, per encounter) was billed by 927 providers across 32.5M claims, totaling $2.37B in Medicaid payments from 2018–2024. This code was used for 4.8M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$39.53
Providers Billing
923
National Spending
$2.37B
Avg/Median Ratio
1.29×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for T1018
| # | Provider | Total Paid |
|---|---|---|
| 1 | Department Of Health And Senior Services Trenton, NJ · Specialist | $938.2M |
| 2 | Newark Public Schools Newark, NJ · Local Education Agency (LEA) | $82.2M |
| 3 | Independent School District 625 Saint Paul, MN · Local Education Agency (LEA) | $42.5M |
| 4 | Paterson Public Schools Paterson, NJ · Local Education Agency (LEA) | $37.0M |
| 5 | 1417080730 | $34.4M |
| 6 | 1619053378 | $32.3M |
| 7 | 1144409863 | $31.2M |
| 8 | 1760696512 | $28.5M |
| 9 | Rochester Independent School District No. 535 Rochester, MN · Local Education Agency (LEA) | $27.5M |
| 10 | 1255403945 | $26.1M |
| 11 | 1104042159 | $23.9M |
| 12 | 1760553572 | $17.5M |
| 13 | 1205966348 | $15.4M |
| 14 | 1003022716 | $14.9M |
| 15 | 1598824716 | $14.5M |
| 16 | 1033279542 | $13.2M |
| 17 | 1124245741 | $13.0M |
| 18 | 1710065909 | $10.7M |
| 19 | 1659456614 | $10.6M |
| 20 | 1467676114 | $10.5M |
Showing top 20 of 927 providers billing this code