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#18 of 11K

T1020

Personal care services, per diem

Personal care services, per diem is the #18 most-billed Medicaid procedure code, with $8.21B in payments across 33.5M claims from 2018–2024. The national median cost per claim is $296.27. Costs vary widely — the 90th percentile is $1,399.61 per claim, 4.7× the median.

Total Paid

$8.21B

0.75% of all spending

Total Claims

33.5M

Providers

1K

Avg Cost/Claim

$245

National Cost Distribution

How much do providers bill per claim for T1020? Based on 1K providers billing this code nationally.

Median

$296.27

Average

$594.25

Std Dev

$1,124.65

Max

$13,886.80

Percentile Distribution (Cost per Claim)

p10
$62.18
p25
$152.42
Median
$296.27
p75
$373.62
p90
$1,399.61
p95
$2,116.78
p99
$5,928.78

50% of providers bill between $152.42 and $373.62 per claim for this code.

90% bill between $62.18 and $1,399.61.

Top 1% bill above $5,928.78.

About This Procedure

HCPCS code T1020 (Personal care services, per diem) was billed by 1K providers across 33.5M claims, totaling $8.21B in Medicaid payments from 2018–2024. This code was used for 5.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$296.27

Providers Billing

1K

National Spending

$8.21B

Avg/Median Ratio

2.01×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for T1020

#ProviderTotal Paid
1Moore Center Services Inc.

Manchester, NH · Early Intervention Provider Agency

$192.2M
2Assistcarehome Healthcare Services

Brooklyn, NY · Home Health

$168.0M
3Premier Home Health Care Services Inc

New York, NY · Home Health

$141.7M
4Gateways Community Services

Nashua, NH · Early Intervention Provider Agency

$138.2M
5Community Bridges

Concord, NH · Case Management

$137.0M
6Concepts Of Independence Inc.

New York, NY · Home Health

$114.2M
7Nae Edison Llc

Brooklyn, NY · Home Health

$113.5M
8Americare Inc.

Brooklyn, NY · Home Health

$109.3M
9Bnv Home Care Agency Inc.

Rego Park, NY · Home Health

$103.4M
10Region Viii, One Sky Community Services Inc.

Portsmouth, NH · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$102.4M
11Platinum Home Health Care Inc.

Brooklyn, NY · Home Health

$99.0M
12All Metro Home Care Services Of New York, Inc.

Lynbrook, NY · Home Health

$98.0M
13Community Health Aide Services Inc.

Monsey, NY · Home Health

$97.8M
14Monadnock Developmental Services

Keene, NH · Case Management

$96.4M
15Northern Human Services

Conway, NH · Clinic/Center, Developmental Disabilities

$94.0M
16Behavioral Health And Developmental Services Of Strafford County, Inc

Dover, NH · Clinic/Center, Developmental Disabilities

$93.0M
17Community Crossroads, Inc.

Atkinson, NH · Day Training, Developmentally Disabled Services

$90.5M
18Bestcare Inc

Levittown, NY · Home Health

$90.5M
19Developmental Services Of Sullivan County, Inc.

Claremont, NH · Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child

$90.1M
20Home Health Care Services Of Ny

Brooklyn, NY · Home Health

$86.8M

Showing top 20 of 1K providers billing this code