96130
Psychological testing evaluation by professional, first hour
Psychological testing evaluation by professional, first hour is the #461 most-billed Medicaid procedure code, with $207.4M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $79.21. Costs vary widely — the 90th percentile is $280.88 per claim, 3.5× the median.
Total Paid
$207.4M
0.02% of all spending
Total Claims
1.6M
Providers
2K
Avg Cost/Claim
$131
National Cost Distribution
How much do providers bill per claim for 96130? Based on 2K providers billing this code nationally.
Median
$79.21
Average
$111.34
Std Dev
$100.18
Max
$952.55
Percentile Distribution (Cost per Claim)
50% of providers bill between $47.15 and $125.99 per claim for this code.
90% bill between $28.14 and $280.88.
Top 1% bill above $360.54.
About This Procedure
HCPCS code 96130 (Psychological testing evaluation by professional, first hour) was billed by 2K providers across 1.6M claims, totaling $207.4M in Medicaid payments from 2018–2024. This code was used for 1.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$79.21
Providers Billing
2K
National Spending
$207.4M
Avg/Median Ratio
1.41×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 96130
| # | Provider | Total Paid |
|---|---|---|
| 1 | Los Angeles Unified School District Los Angeles, CA · Social Worker School | $11.4M |
| 2 | 1861528390 | $4.7M |
| 3 | 1588709869 | $3.1M |
| 4 | 1033291331 | $2.7M |
| 5 | 1639395346 | $1.9M |
| 6 | 1740338011 | $1.9M |
| 7 | 1891885604 | $1.8M |
| 8 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $1.7M |
| 9 | Wasatch Behavioral Health Special Service District Provo, UT · Community/Behavioral Health | $1.7M |
| 10 | 1619553963 | $1.5M |
| 11 | 1710189352 | $1.5M |
| 12 | 1073630505 | $1.5M |
| 13 | 1043388648 | $1.5M |
| 14 | Children's Specialized Hospital New Brunswick, NJ · Pediatrics | $1.5M |
| 15 | 1326194671 | $1.4M |
| 16 | 1871715128 | $1.4M |
| 17 | 1902377864 | $1.3M |
| 18 | 1427180835 | $1.3M |
| 19 | 1699813824 | $1.3M |
| 20 | 1437206091 | $1.2M |
Showing top 20 of 2K providers billing this code