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#55 of 11K

T2025

Waiver services, NOS; per 15 min

Waiver services, NOS; per 15 min is the #55 most-billed Medicaid procedure code, with $3.63B in payments across 20.5M claims from 2018–2024. The national median cost per claim is $124.39. Costs vary widely — the 90th percentile is $669.75 per claim, 5.4× the median.

Total Paid

$3.63B

0.33% of all spending

Total Claims

20.5M

Providers

690

Avg Cost/Claim

$177

National Cost Distribution

How much do providers bill per claim for T2025? Based on 635 providers billing this code nationally.

Median

$124.39

Average

$303.77

Std Dev

$736.10

Max

$11,840.62

Percentile Distribution (Cost per Claim)

p10
$42.38
p25
$69.73
Median
$124.39
p75
$287.57
p90
$669.75
p95
$946.92
p99
$2,483.33

50% of providers bill between $69.73 and $287.57 per claim for this code.

90% bill between $42.38 and $669.75.

Top 1% bill above $2,483.33.

About This Procedure

HCPCS code T2025 (Waiver services, NOS; per 15 min) was billed by 690 providers across 20.5M claims, totaling $3.63B in Medicaid payments from 2018–2024. This code was used for 2.9M unique beneficiaries.

Risk Assessment

This procedure is featured in our investigation: NY Home Care Machine

Read the full analysis for context on billing patterns associated with this code.

Billing Statistics

Median Cost/Claim

$124.39

Providers Billing

635

National Spending

$3.63B

Avg/Median Ratio

2.44×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for T2025

#ProviderTotal Paid
1Public Partnerships-colorado Inc.

Boston, MA · Supports Brokerage

$864.1M
2Public Partnerships Llc

Latham, NY · Supports Brokerage

$178.7M
3Department Of Intellectual And Developmental Disabilities, State Of Tn

Nashville, TN · Public Health or Welfare

$176.0M
4Palco, Inc.

Maumelle, AR · Supports Brokerage

$160.7M
5Mosaic

Newark, DE · Community Based Residential Treatment Facility Mental Illness

$113.9M
6Chimes Metro Inc.

Newark, DE · Psychologist Intellectual & Developmental Disabilities

$113.1M
7Keystone Service Systems Inc.

Newark, DE · Psychologist Intellectual & Developmental Disabilities

$77.8M
8Moore Center Services Inc.

Manchester, NH · Early Intervention Provider Agency

$67.9M
9Gateways Community Services

Nashua, NH · Early Intervention Provider Agency

$65.9M
10Acumen Fiscal Agent Llc

Mesa, AZ · Community/Behavioral Health

$63.0M
11National Mentor Healthcare Llc

Millsboro, DE · Psychologist Intellectual & Developmental Disabilities

$58.1M
12Community Bridges

Concord, NH · Case Management

$54.1M
13Community Systems Inc.

Newark, DE · Psychologist Intellectual & Developmental Disabilities

$50.9M
141285777490$48.8M
15Visiting Nurse Group Inc

Philadelphia, PA · Home Health

$34.1M
16Resources For Human Development Inc.

Newark, DE · Psychologist Intellectual & Developmental Disabilities

$33.9M
17Region Viii, One Sky Community Services Inc.

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

$33.7M
18Kencrest Services

Blue Bell, PA · Psychologist, Intellectual & Developmental Disabilities

$33.5M
19Community Crossroads, Inc.

Atkinson, NH · Day Training, Developmentally Disabled Services

$33.3M
20Health Managment Of Kansas, Inc.

Coffeyville, KS · Home Health

$32.7M

Showing top 20 of 690 providers billing this code