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#520 of 11K

0365T

Adaptive behavior treatment, each additional thirty minutes

Adaptive behavior treatment, each additional thirty minutes is the #520 most-billed Medicaid procedure code, with $168.7M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $106.05.

Total Paid

$168.7M

0.02% of all spending

Total Claims

1.3M

Providers

242

Avg Cost/Claim

$133

National Cost Distribution

How much do providers bill per claim for 0365T? Based on 239 providers billing this code nationally.

Median

$106.05

Average

$118.16

Std Dev

$67.92

Max

$444.29

Percentile Distribution (Cost per Claim)

p10
$46.48
p25
$70.92
Median
$106.05
p75
$155.22
p90
$190.85
p95
$243.36
p99
$338.68

50% of providers bill between $70.92 and $155.22 per claim for this code.

90% bill between $46.48 and $190.85.

Top 1% bill above $338.68.

About This Procedure

HCPCS code 0365T (Adaptive behavior treatment, each additional thirty minutes) was billed by 242 providers across 1.3M claims, totaling $168.7M in Medicaid payments from 2018–2024. This code was used for 85K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$106.05

Providers Billing

239

National Spending

$168.7M

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0365T

#ProviderTotal Paid
1Centria Healthcare Llc

Farmington Hills, MI · Home Health

$43.1M
2Gateway Pediatric Therapy Llc

Bingham Farms, MI · Behavior Analyst

$9.9M
31669651675$6.9M
4Macomb Oakland Regional Center Inc.

Auburn Hills, MI · Community/Behavioral Health

$4.5M
51609135748$3.5M
61598007171$2.8M
71851478622$2.8M
81821494584$2.7M
91891917449$2.7M
101518366285$2.5M
11Residential Options Inc.

Lansing, MI · Behavior Analyst

$2.0M
121770838468$2.0M
13Genesee Health System

Flint, MI · Community/Behavioral Health

$1.8M
141740670454$1.8M
151801289020$1.8M
161023454451$1.6M
17Eric Lund

Green Bay, WI · Psychologist Clinical

$1.6M
181508246745$1.5M
19Hope Network Behavioral Health Services

Nunica, MI · Psychiatry & Neurology, Child & Adolescent Psychiatry

$1.4M
201417477175$1.3M

Showing top 20 of 242 providers billing this code