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#712 of 11K

96156

HCPCS Procedure Code

HCPCS code 96156 is the #712 most-billed Medicaid procedure code, with $99.9M in payments across 3.4M claims from 2018–2024. The national median cost per claim is $22.36. Costs vary widely — the 90th percentile is $98.43 per claim, 4.4× the median.

Total Paid

$99.9M

0.01% of all spending

Total Claims

3.4M

Providers

2K

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for 96156? Based on 2K providers billing this code nationally.

Median

$22.36

Average

$40.82

Std Dev

$47.51

Max

$402.81

Percentile Distribution (Cost per Claim)

p10
$0.71
p25
$6.58
Median
$22.36
p75
$65.18
p90
$98.43
p95
$114.85
p99
$231.11

50% of providers bill between $6.58 and $65.18 per claim for this code.

90% bill between $0.71 and $98.43.

Top 1% bill above $231.11.

About This Procedure

HCPCS code 96156 was billed by 2K providers across 3.4M claims, totaling $99.9M in Medicaid payments from 2018–2024. This code was used for 3.1M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$22.36

Providers Billing

2K

National Spending

$99.9M

Avg/Median Ratio

1.83×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 96156

#ProviderTotal Paid
1Wv Birth To Three

Charleston, WV · Early Intervention Provider Agency

$6.2M
21568495364$4.4M
31427121375$2.7M
41003902610$1.9M
51265569008$1.5M
61366574048$1.5M
71659312593$1.4M
81982871729$1.3M
91831722610$1.2M
101881801835$1.2M
111780169524$1.2M
121386273100$1.1M
131952781411$1.1M
14Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$1.1M
151871607762$1.1M
161831400795$1.1M
171114192390$1.0M
181871818138$991K
191568599769$959K
201508982455$949K

Showing top 20 of 2K providers billing this code