96152
Health behavior intervention, individual
Health behavior intervention, individual is the #525 most-billed Medicaid procedure code, with $165.4M in payments across 2.8M claims from 2018–2024. The national median cost per claim is $20.02. Costs vary widely — the 90th percentile is $114.62 per claim, 5.7× the median.
Total Paid
$165.4M
0.02% of all spending
Total Claims
2.8M
Providers
1K
Avg Cost/Claim
$59
National Cost Distribution
How much do providers bill per claim for 96152? Based on 1K providers billing this code nationally.
Median
$20.02
Average
$41.14
Std Dev
$59.05
Max
$665.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.98 and $38.76 per claim for this code.
90% bill between $6.03 and $114.62.
Top 1% bill above $265.50.
About This Procedure
HCPCS code 96152 (Health behavior intervention, individual) was billed by 1K providers across 2.8M claims, totaling $165.4M in Medicaid payments from 2018–2024. This code was used for 721K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$20.02
Providers Billing
1K
National Spending
$165.4M
Avg/Median Ratio
2.05×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 96152
| # | Provider | Total Paid |
|---|---|---|
| 1 | Hopebridge, Llc Kokomo, IN · Assistant Behavior Analyst | $19.6M |
| 2 | Joint School District No. 2 Meridian, ID · Local Education Agency (LEA) | $6.7M |
| 3 | 1447562434 | $6.1M |
| 4 | 1538150081 | $4.1M |
| 5 | 1427154814 | $3.7M |
| 6 | 1154482982 | $3.2M |
| 7 | 1770706160 | $3.2M |
| 8 | 1346343217 | $3.0M |
| 9 | 1831227263 | $2.9M |
| 10 | 1003960659 | $2.6M |
| 11 | Los Angeles Unified School District Los Angeles, CA · Social Worker School | $2.5M |
| 12 | 1265587042 | $2.4M |
| 13 | Baltimore City Schools Baltimore, MD · Local Education Agency (LEA) | $2.4M |
| 14 | 1043366099 | $2.4M |
| 15 | 1932260841 | $2.2M |
| 16 | 1689776718 | $2.1M |
| 17 | 1770755878 | $2.1M |
| 18 | 1285804732 | $2.1M |
| 19 | 1548566201 | $1.9M |
| 20 | 1215090196 | $1.9M |
Showing top 20 of 1K providers billing this code