#1551 of 11K

0368T

HCPCS Procedure Code

HCPCS code 0368T is the #1,551 most-billed Medicaid procedure code, with $19.5M in payments across 387K claims from 2018–2024. The national median cost per claim is $44.63.

Total Paid

$19.5M

0.00% of all spending

Total Claims

387K

Providers

254

Avg Cost/Claim

$50

National Cost Distribution

How much do providers bill per claim for 0368T? Based on 252 providers billing this code nationally.

Median

$44.63

Average

$49.95

Std Dev

$35.65

Max

$307.10

Percentile Distribution (Cost per Claim)

p10

$24.20

p25

$29.34

Median

$44.63

p75

$59.41

p90

$72.17

p95

$94.36

p99

$244.95

50% of providers bill between $29.34 and $59.41 per claim for this code.

90% bill between $24.20 and $72.17.

Top 1% bill above $244.95.

About This Procedure

HCPCS code 0368T was billed by 254 providers across 387K claims, totaling $19.5M in Medicaid payments from 2018–2024. This code was used for 85K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$44.63

Providers Billing

252

National Spending

$19.5M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0368T

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Centria Healthcare Llc Farmington Hills, MI · Home Health	$2.9M	$60.20	1.3× median	Above 75th
2	1104119619	$754K	$72.89	1.6× median	Top 10%
3	Gateway Pediatric Therapy Llc Bingham Farms, MI · Behavior Analyst	$716K	$58.73	1.3× median	Above Median
4	1962765693	$700K	$53.21	1.2× median	Above Median
5	Eric Lund Green Bay, WI · Psychologist Clinical	$430K	$26.82	0.6× median	Below Median
6	1598007171	$429K	$57.53	1.3× median	Above Median
7	1912242918	$426K	$307.10	6.9× median	Top 1%
8	1801289020	$401K	$28.33	0.6× median	Below Median
9	1124198494	$372K	$93.52	2.1× median	Top 10%
10	1821494584	$359K	$28.89	0.6× median	Below Median
11	1205061926	$306K	$103.37	2.3× median	Top 10%
12	Residential Options Inc. Lansing, MI · Behavior Analyst	$304K	$52.18	1.2× median	Above Median
13	1891917449	$293K	$88.09	2.0× median	Top 10%
14	Macomb Oakland Regional Center Inc. Auburn Hills, MI · Community/Behavioral Health	$279K	$86.34	1.9× median	Top 10%
15	1518366285	$273K	$74.54	1.7× median	Top 10%
16	1447694831	$266K	$109.22	2.4× median	Top 10%
17	1609135748	$258K	$60.01	1.3× median	Above 75th
18	Community Mental Health For Central Michigan Mt Pleasant, MI · Psychiatry & Neurology Psychiatry	$248K	$268.83	6.0× median	Top 1%
19	1972895290	$230K	$272.56	6.1× median	Top 1%
20	Genesee Health System Flint, MI · Community/Behavioral Health	$228K	$58.84	1.3× median	Above Median

Showing top 20 of 254 providers billing this code

Related Procedures

0365TAdaptive behavior treatment, each additional thirty minutes$168.7M 0364T$39.9M 0369T$38.1M 0373T$8.7M 0370T$5.3M

← All procedures Top providers →