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#3368 of 11K

97001

HCPCS Procedure Code

HCPCS code 97001 is the #3,368 most-billed Medicaid procedure code, with $1.8M in payments across 44K claims from 2018–2024. The national median cost per claim is $50.40.

Total Paid

$1.8M

0.00% of all spending

Total Claims

44K

Providers

176

Avg Cost/Claim

$42

National Cost Distribution

How much do providers bill per claim for 97001? Based on 160 providers billing this code nationally.

Median

$50.40

Average

$61.62

Std Dev

$47.07

Max

$504.91

Percentile Distribution (Cost per Claim)

p10
$24.82
p25
$38.76
Median
$50.40
p75
$77.57
p90
$99.10
p95
$126.31
p99
$157.90

50% of providers bill between $38.76 and $77.57 per claim for this code.

90% bill between $24.82 and $99.10.

Top 1% bill above $157.90.

About This Procedure

HCPCS code 97001 was billed by 176 providers across 44K claims, totaling $1.8M in Medicaid payments from 2018–2024. This code was used for 37K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$50.40

Providers Billing

160

National Spending

$1.8M

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 97001

#ProviderTotal Paid
1Kid Success Inc.

Conway, AR · Clinic/Center Rehabilitation

$144K
21215967831$92K
31922043686$88K
4Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$85K
51316902414$60K
61477549756$59K
71568433480$56K
8Full Potential

Little Rock, AR · Clinic/Center Primary Care

$53K
91043304942$52K
10Los Angeles Unified School District

Los Angeles, CA · Social Worker School

$49K
111871755223$39K
121689628232$36K
13Kids For The Future Of Forrest City Inc.

Forrest City, AR · Early Intervention Provider Agency

$35K
141912288309$28K
151811047921$28K
161659581932$27K
171699726695$25K
181497770424$24K
191285602946$23K
201386964351$22K

Showing top 20 of 176 providers billing this code