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#6034 of 11K

95249

HCPCS Procedure Code

HCPCS code 95249 is the #6,034 most-billed Medicaid procedure code, with $103K in payments across 4,963 claims from 2018–2024. The national median cost per claim is $19.95. Costs vary widely — the 90th percentile is $50.64 per claim, 2.5× the median.

Total Paid

$103K

0.00% of all spending

Total Claims

4,963

Providers

52

Avg Cost/Claim

$21

National Cost Distribution

How much do providers bill per claim for 95249? Based on 49 providers billing this code nationally.

Median

$19.95

Average

$24.92

Std Dev

$21.40

Max

$121.43

Percentile Distribution (Cost per Claim)

p10
$3.58
p25
$9.99
Median
$19.95
p75
$34.16
p90
$50.64
p95
$54.84
p99
$92.45

50% of providers bill between $9.99 and $34.16 per claim for this code.

90% bill between $3.58 and $50.64.

Top 1% bill above $92.45.

About This Procedure

HCPCS code 95249 was billed by 52 providers across 4,963 claims, totaling $103K in Medicaid payments from 2018–2024. This code was used for 4,531 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.95

Providers Billing

49

National Spending

$103K

Avg/Median Ratio

1.25×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95249

#ProviderTotal Paid
11083971881$12K
21245248939$11K
3Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$8K
41750895835$8K
5Mount Sinai Hospital

New York, NY · Ambulance

$8K
6Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$7K
71689979569$7K
81124098421$6K
91619082625$4K
10State Of Connecticut

Farmington, CT · Counselor, Professional

$3K
111154751931$2K
12Saint Francis Hospital And Medical Center

Hartford, CT · General Acute Care Hospital

$2K
131407059199$2K
141578583951$2K
151649726738$2K
161740475664$2K
171437111028$1K
181003994252$1K
191073680419$1K
201265994636$1K

Showing top 20 of 52 providers billing this code

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