96158
HCPCS Procedure Code
HCPCS code 96158 is the #677 most-billed Medicaid procedure code, with $107.5M in payments across 3.5M claims from 2018–2024. The national median cost per claim is $28.43.
Total Paid
$107.5M
0.01% of all spending
Total Claims
3.5M
Providers
1K
Avg Cost/Claim
$31
National Cost Distribution
How much do providers bill per claim for 96158? Based on 1K providers billing this code nationally.
Median
$28.43
Average
$33.95
Std Dev
$36.82
Max
$806.39
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.07 and $46.93 per claim for this code.
90% bill between $10.58 and $52.62.
Top 1% bill above $105.31.
About This Procedure
HCPCS code 96158 was billed by 1K providers across 3.5M claims, totaling $107.5M in Medicaid payments from 2018–2024. This code was used for 1.4M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$28.43
Providers Billing
1K
National Spending
$107.5M
Avg/Median Ratio
1.19×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 96158
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Board Of Education Of The City Of Chicago Chicago, IL · Local Education Agency (LEA) | $18.3M |
| 2 | Los Angeles Unified School District Los Angeles, CA · Social Worker School | $4.6M |
| 3 | 1700054780 | $1.2M |
| 4 | 1033291331 | $1.2M |
| 5 | 1154482982 | $1.2M |
| 6 | 1043366099 | $1.0M |
| 7 | 1982732566 | $948K |
| 8 | 1750559787 | $780K |
| 9 | 1598019721 | $765K |
| 10 | 1962670091 | $752K |
| 11 | 1932260841 | $720K |
| 12 | 1700934395 | $705K |
| 13 | 1639395346 | $705K |
| 14 | 1033426739 | $700K |
| 15 | 1437759107 | $692K |
| 16 | 1326216300 | $672K |
| 17 | 1689875643 | $662K |
| 18 | 1104947704 | $609K |
| 19 | 1902041585 | $609K |
| 20 | 1811024573 | $594K |
Showing top 20 of 1K providers billing this code