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#946 of 11K

T1028

Assessment of home, physical & family environments

Assessment of home, physical & family environments is the #946 most-billed Medicaid procedure code, with $56.0M in payments across 596K claims from 2018–2024. The national median cost per claim is $81.30. Costs vary widely — the 90th percentile is $242.38 per claim, 3.0× the median.

Total Paid

$56.0M

0.01% of all spending

Total Claims

596K

Providers

383

Avg Cost/Claim

$94

National Cost Distribution

How much do providers bill per claim for T1028? Based on 356 providers billing this code nationally.

Median

$81.30

Average

$134.45

Std Dev

$254.96

Max

$2,500.00

Percentile Distribution (Cost per Claim)

p10
$52.45
p25
$72.10
Median
$81.30
p75
$100.05
p90
$242.38
p95
$266.62
p99
$1,324.47

50% of providers bill between $72.10 and $100.05 per claim for this code.

90% bill between $52.45 and $242.38.

Top 1% bill above $1,324.47.

About This Procedure

HCPCS code T1028 (Assessment of home, physical & family environments) was billed by 383 providers across 596K claims, totaling $56.0M in Medicaid payments from 2018–2024. This code was used for 543K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$81.30

Providers Billing

356

National Spending

$56.0M

Avg/Median Ratio

1.65×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for T1028

#ProviderTotal Paid
11528679867$5.4M
21932227790$5.3M
31619477841$4.5M
41720466659$4.0M
5Whybee

Brooklyn, NY · Case Management

$2.4M
61497236418$2.1M
7Seniorage Area Agency On Aging

Springfield, MO · Meals

$1.3M
81598131674$1.2M
91780424044$1.1M
101285206169$1.1M
111942743810$1.0M
121932643871$1.0M
13Caregiver Homes Of Massachusetts Inc

Auburn, MA · Case Management

$986K
141003819103$973K
151992263040$871K
16A532015100$693K
17A707657300$575K
181174172092$574K
191013421643$555K
201417075862$494K

Showing top 20 of 383 providers billing this code