95251
HCPCS Procedure Code
HCPCS code 95251 is the #1,829 most-billed Medicaid procedure code, with $13.1M in payments across 646K claims from 2018–2024. The national median cost per claim is $18.02.
Total Paid
$13.1M
0.00% of all spending
Total Claims
646K
Providers
1,349
Avg Cost/Claim
$20
National Cost Distribution
How much do providers bill per claim for 95251? Based on 1,309 providers billing this code nationally.
Median
$18.02
Average
$19.38
Std Dev
$13.12
Max
$191.41
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.46 and $24.11 per claim for this code.
90% bill between $6.37 and $31.26.
Top 1% bill above $61.09.
About This Procedure
HCPCS code 95251 was billed by 1,349 providers across 646K claims, totaling $13.1M in Medicaid payments from 2018–2024. This code was used for 597K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$18.02
Providers Billing
1,309
National Spending
$13.1M
Avg/Median Ratio
1.08×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 95251
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1134163942 | $244K |
| 2 | 1366425274 | $208K |
| 3 | 1407100183 | $178K |
| 4 | 1275628224 | $164K |
| 5 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $151K |
| 6 | 1689979569 | $150K |
| 7 | 1053441907 | $150K |
| 8 | 1831248236 | $149K |
| 9 | 1508266347 | $147K |
| 10 | 1144309188 | $136K |
| 11 | 1194099390 | $135K |
| 12 | 1548288160 | $125K |
| 13 | 1144556333 | $121K |
| 14 | Vanderbilt University Medical Center Nashville, TN · Transplant Surgery | $115K |
| 15 | 1932208808 | $114K |
| 16 | 1457396541 | $112K |
| 17 | Texas Children's Physician Group Houston, TX · Pediatrics | $109K |
| 18 | 1043680515 | $106K |
| 19 | 1811125644 | $104K |
| 20 | The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities | $103K |
Showing top 20 of 1,349 providers billing this code