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#1113 of 11K

0364T

HCPCS Procedure Code

HCPCS code 0364T is the #1,113 most-billed Medicaid procedure code, with $39.9M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $21.31.

Total Paid

$39.9M

0.00% of all spending

Total Claims

1.3M

Providers

257

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for 0364T? Based on 254 providers billing this code nationally.

Median

$21.31

Average

$26.47

Std Dev

$23.31

Max

$201.34

Percentile Distribution (Cost per Claim)

p10
$11.68
p25
$15.09
Median
$21.31
p75
$27.53
p90
$42.60
p95
$82.36
p99
$125.69

50% of providers bill between $15.09 and $27.53 per claim for this code.

90% bill between $11.68 and $42.60.

Top 1% bill above $125.69.

About This Procedure

HCPCS code 0364T was billed by 257 providers across 1.3M claims, totaling $39.9M in Medicaid payments from 2018–2024. This code was used for 94K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$21.31

Providers Billing

254

National Spending

$39.9M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0364T

#ProviderTotal Paid
1Centria Healthcare Llc

Farmington Hills, MI · Home Health

$6.1M
21104119619$4.9M
31962765693$2.1M
41972934537$1.5M
5Gateway Pediatric Therapy Llc

Bingham Farms, MI · Behavior Analyst

$1.4M
61669651675$882K
71447694831$767K
8Macomb Oakland Regional Center Inc.

Auburn Hills, MI · Community/Behavioral Health

$686K
91891898045$663K
101396085718$654K
111609135748$573K
121598007171$505K
131821494584$501K
141851478622$460K
15Eric Lund

Green Bay, WI · Psychologist Clinical

$445K
161518366285$431K
17Genesee Health System

Flint, MI · Community/Behavioral Health

$399K
181891172094$397K
191740670454$368K
201639571755$361K

Showing top 20 of 257 providers billing this code