T1031
Nursing care, in the home, by LPN, per diem
Nursing care, in the home, by LPN, per diem is the #1,279 most-billed Medicaid procedure code, with $29.5M in payments across 498K claims from 2018–2024. The national median cost per claim is $80.56.
Total Paid
$29.5M
0.00% of all spending
Total Claims
498K
Providers
144
Avg Cost/Claim
$59
National Cost Distribution
How much do providers bill per claim for T1031? Based on 140 providers billing this code nationally.
Median
$80.56
Average
$79.04
Std Dev
$49.46
Max
$442.68
Percentile Distribution (Cost per Claim)
50% of providers bill between $59.82 and $96.28 per claim for this code.
90% bill between $25.61 and $114.52.
Top 1% bill above $237.68.
About This Procedure
HCPCS code T1031 (Nursing care, in the home, by LPN, per diem) was billed by 144 providers across 498K claims, totaling $29.5M in Medicaid payments from 2018–2024. This code was used for 91K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$80.56
Providers Billing
140
National Spending
$29.5M
Avg/Median Ratio
0.98×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for T1031
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1003872862 | $3.3M |
| 2 | 1295157790 | $2.5M |
| 3 | 1194099127 | $2.3M |
| 4 | 1134104573 | $1.9M |
| 5 | 1629023056 | $1.4M |
| 6 | Southern Home Care Services Inc. Valdosta, GA · Home Health | $1.1M |
| 7 | 1942580659 | $805K |
| 8 | 1063420198 | $772K |
| 9 | 1033390406 | $757K |
| 10 | Americare Certified Special Services Inc. Brooklyn, NY · Home Health | $663K |
| 11 | 1730171547 | $660K |
| 12 | 1699772343 | $591K |
| 13 | 1093082893 | $579K |
| 14 | 1497826515 | $559K |
| 15 | 1942489398 | $511K |
| 16 | 1649285354 | $491K |
| 17 | 1184073058 | $461K |
| 18 | 1720019144 | $454K |
| 19 | 1528433521 | $395K |
| 20 | 1467502070 | $357K |
Showing top 20 of 144 providers billing this code