W7210
Waiver service, state-specific code
Waiver service, state-specific code is the #223 most-billed Medicaid procedure code, with $687.1M in payments across 8.4M claims from 2018–2024. The national median cost per claim is $80.31.
Total Paid
$687.1M
0.06% of all spending
Total Claims
8.4M
Providers
70
Avg Cost/Claim
$81
National Cost Distribution
How much do providers bill per claim for W7210? Based on 70 providers billing this code nationally.
Median
$80.31
Average
$82.68
Std Dev
$15.76
Max
$118.48
Percentile Distribution (Cost per Claim)
50% of providers bill between $71.34 and $92.00 per claim for this code.
90% bill between $65.02 and $106.13.
Top 1% bill above $114.57.
About This Procedure
HCPCS code W7210 (Waiver service, state-specific code) was billed by 70 providers across 8.4M claims, totaling $687.1M in Medicaid payments from 2018–2024. This code was used for 2.4M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$80.31
Providers Billing
70
National Spending
$687.1M
Avg/Median Ratio
1.03×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for W7210
| # | Provider | Total Paid |
|---|---|---|
| 1 | Service Access And Management Inc Reading, PA · Community/Behavioral Health | $76.9M |
| 2 | 1790864312 | $44.0M |
| 3 | 1093832214 | $32.5M |
| 4 | 1235100744 | $30.9M |
| 5 | 1902023005 | $29.8M |
| 6 | 1366573511 | $27.0M |
| 7 | 1114047966 | $26.3M |
| 8 | 1457611345 | $22.6M |
| 9 | 1639206162 | $21.3M |
| 10 | 1720125420 | $21.3M |
| 11 | 1023138872 | $20.2M |
| 12 | 1164734455 | $19.9M |
| 13 | 1528180320 | $18.9M |
| 14 | 1063538627 | $17.1M |
| 15 | 1407978174 | $16.0M |
| 16 | 1780964692 | $15.6M |
| 17 | 1497749709 | $15.1M |
| 18 | 1104886365 | $14.1M |
| 19 | 1790828838 | $12.8M |
| 20 | 1427273911 | $12.6M |
Showing top 20 of 70 providers billing this code