96154
HCPCS Procedure Code
HCPCS code 96154 is the #3,587 most-billed Medicaid procedure code, with $1.5M in payments across 69K claims from 2018–2024. The national median cost per claim is $36.72. Costs vary widely — the 90th percentile is $81.60 per claim, 2.2× the median.
Total Paid
$1.5M
0.00% of all spending
Total Claims
69K
Providers
103
Avg Cost/Claim
$21
National Cost Distribution
How much do providers bill per claim for 96154? Based on 86 providers billing this code nationally.
Median
$36.72
Average
$42.17
Std Dev
$32.33
Max
$120.40
Percentile Distribution (Cost per Claim)
50% of providers bill between $16.31 and $66.44 per claim for this code.
90% bill between $1.69 and $81.60.
Top 1% bill above $107.31.
About This Procedure
HCPCS code 96154 was billed by 103 providers across 69K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 53K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$36.72
Providers Billing
86
National Spending
$1.5M
Avg/Median Ratio
1.15×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 96154
| # | Provider | Total Paid |
|---|---|---|
| 1 | Stillaguamish Tribe Of Indians Arlington, WA · Clinic/Center Rehabilitation Substance Use Disorder | $277K |
| 2 | 1407979289 | $147K |
| 3 | 1689709172 | $83K |
| 4 | 1275579906 | $75K |
| 5 | 1205835634 | $62K |
| 6 | Montefiore Medical Center Bronx, NY · Anesthesiology | $61K |
| 7 | 1790943066 | $56K |
| 8 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $54K |
| 9 | 1396068300 | $51K |
| 10 | 1043531007 | $49K |
| 11 | 1821367137 | $44K |
| 12 | 1669411377 | $34K |
| 13 | 1245312842 | $29K |
| 14 | District Medical Group, Inc Phoenix, AZ · Anesthesiology | $27K |
| 15 | 1073765095 | $26K |
| 16 | 1417244989 | $23K |
| 17 | 1265441877 | $20K |
| 18 | 1538339874 | $20K |
| 19 | 1851328082 | $18K |
| 20 | 1982737979 | $18K |
Showing top 20 of 103 providers billing this code