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#5937 of 11K

95805

HCPCS Procedure Code

HCPCS code 95805 is the #5,937 most-billed Medicaid procedure code, with $116K in payments across 533 claims from 2018–2024. The national median cost per claim is $172.64. Costs vary widely — the 90th percentile is $507.16 per claim, 2.9× the median.

Total Paid

$116K

0.00% of all spending

Total Claims

533

Providers

14

Avg Cost/Claim

$218

National Cost Distribution

How much do providers bill per claim for 95805? Based on 14 providers billing this code nationally.

Median

$172.64

Average

$217.52

Std Dev

$205.72

Max

$641.38

Percentile Distribution (Cost per Claim)

p10
$27.39
p25
$42.27
Median
$172.64
p75
$345.78
p90
$507.16
p95
$569.29
p99
$626.96

50% of providers bill between $42.27 and $345.78 per claim for this code.

90% bill between $27.39 and $507.16.

Top 1% bill above $626.96.

About This Procedure

HCPCS code 95805 was billed by 14 providers across 533 claims, totaling $116K in Medicaid payments from 2018–2024. This code was used for 454 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$172.64

Providers Billing

14

National Spending

$116K

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 95805

#ProviderTotal Paid
11346406469$36K
21316010952$33K
3Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$17K
41154372340$6K
5Optum Medical Care Of New Jersey Pc

Secaucus, NJ · Durable Medical Equipment & Medical Supplies

$6K
61306809397$5K
71538564463$3K
81275739351$2K
91275588147$2K
101649227265$2K
11Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$1K
121912194135$804
131811920549$632
141285079764$43

Showing top 14 of 14 providers billing this code