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#3387 of 11K

97003

HCPCS Procedure Code

HCPCS code 97003 is the #3,387 most-billed Medicaid procedure code, with $1.8M in payments across 33K claims from 2018–2024. The national median cost per claim is $98.97.

Total Paid

$1.8M

0.00% of all spending

Total Claims

33K

Providers

220

Avg Cost/Claim

$55

National Cost Distribution

How much do providers bill per claim for 97003? Based on 189 providers billing this code nationally.

Median

$98.97

Average

$87.89

Std Dev

$34.93

Max

$188.69

Percentile Distribution (Cost per Claim)

p10
$37.81
p25
$64.14
Median
$98.97
p75
$106.99
p90
$120.66
p95
$135.16
p99
$178.53

50% of providers bill between $64.14 and $106.99 per claim for this code.

90% bill between $37.81 and $120.66.

Top 1% bill above $178.53.

About This Procedure

HCPCS code 97003 was billed by 220 providers across 33K claims, totaling $1.8M in Medicaid payments from 2018–2024. This code was used for 24K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$98.97

Providers Billing

189

National Spending

$1.8M

Avg/Median Ratio

0.89×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 97003

#ProviderTotal Paid
1Los Angeles Unified School District

Los Angeles, CA · Social Worker School

$165K
2Kid Success Inc.

Conway, AR · Clinic/Center Rehabilitation

$136K
31588709869$64K
41871755223$62K
51669690830$46K
61356313340$44K
71922470608$42K
81740338011$35K
91912198730$35K
101811047921$32K
111669513404$26K
121639395346$25K
131497897292$21K
141629280128$21K
15First Step Inc.

Hot Springs, AR · Day Training Developmentally Disabled Services

$20K
16Kids For The Future Of Forrest City Inc.

Forrest City, AR · Early Intervention Provider Agency

$20K
171558418392$20K
181851476931$20K
191427180835$20K
201477549756$19K

Showing top 20 of 220 providers billing this code