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#1203 of 11K

90868

HCPCS Procedure Code

HCPCS code 90868 is the #1,203 most-billed Medicaid procedure code, with $33.6M in payments across 275K claims from 2018–2024. The national median cost per claim is $140.66.

Total Paid

$33.6M

0.00% of all spending

Total Claims

275K

Providers

113

Avg Cost/Claim

$122

National Cost Distribution

How much do providers bill per claim for 90868? Based on 101 providers billing this code nationally.

Median

$140.66

Average

$131.06

Std Dev

$66.41

Max

$400.59

Percentile Distribution (Cost per Claim)

p10
$53.96
p25
$86.97
Median
$140.66
p75
$169.57
p90
$191.01
p95
$215.38
p99
$346.55

50% of providers bill between $86.97 and $169.57 per claim for this code.

90% bill between $53.96 and $191.01.

Top 1% bill above $346.55.

About This Procedure

HCPCS code 90868 was billed by 113 providers across 275K claims, totaling $33.6M in Medicaid payments from 2018–2024. This code was used for 28K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$140.66

Providers Billing

101

National Spending

$33.6M

Avg/Median Ratio

0.93×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90868

#ProviderTotal Paid
11790309862$3.1M
21710415617$3.1M
31881287787$2.2M
41275822751$2.2M
51578258281$1.8M
61295266302$1.6M
71871372003$1.5M
81740998202$1.4M
91841928397$1.2M
101811280183$906K
111255911582$865K
12Northeast Health Services, Llc

Taunton, MA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$836K
131962094714$780K
141316460850$718K
151902565930$608K
161528628633$452K
171700440203$441K
181881139913$418K
191669241535$392K
201366005183$384K

Showing top 20 of 113 providers billing this code