97124
HCPCS Procedure Code
HCPCS code 97124 is the #537 most-billed Medicaid procedure code, with $159.1M in payments across 3.1M claims from 2018–2024. The national median cost per claim is $17.78. Costs vary widely — the 90th percentile is $85.15 per claim, 4.8× the median.
Total Paid
$159.1M
0.01% of all spending
Total Claims
3.1M
Providers
937
Avg Cost/Claim
$51
National Cost Distribution
How much do providers bill per claim for 97124? Based on 843 providers billing this code nationally.
Median
$17.78
Average
$37.66
Std Dev
$63.84
Max
$637.22
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.06 and $45.97 per claim for this code.
90% bill between $0.93 and $85.15.
Top 1% bill above $378.82.
About This Procedure
HCPCS code 97124 was billed by 937 providers across 3.1M claims, totaling $159.1M in Medicaid payments from 2018–2024. This code was used for 943K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$17.78
Providers Billing
843
National Spending
$159.1M
Avg/Median Ratio
2.12×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 97124
| # | Provider | Total Paid |
|---|---|---|
| 1 | Disability Services Of The Southwest, Inc San Antonio, TX · Day Training, Developmentally Disabled Services | $31.8M |
| 2 | Caregivers Home Health Tx Inc Richardson, TX · Nursing Care | $22.4M |
| 3 | Astrocare Class, Inc. Houston, TX · Home Health | $9.4M |
| 4 | 1366522096 | $2.9M |
| 5 | 1346579265 | $2.5M |
| 6 | 1962740241 | $2.1M |
| 7 | 1336454461 | $2.1M |
| 8 | 1467842591 | $2.0M |
| 9 | 1154449890 | $2.0M |
| 10 | 1568591725 | $1.9M |
| 11 | First Primary Home Care, Inc Harlingen, TX · Hospice Care, Community Based | $1.8M |
| 12 | 1689821860 | $1.7M |
| 13 | 1093172520 | $1.7M |
| 14 | 1619107695 | $1.7M |
| 15 | 1306023429 | $1.7M |
| 16 | 1053784256 | $1.4M |
| 17 | Texas Visiting Nurse Service, Ltd. Harlingen, TX · Emergency Response System Companies | $1.3M |
| 18 | 1386052652 | $1.3M |
| 19 | 1295876829 | $1.2M |
| 20 | 1780988261 | $1.2M |
Showing top 20 of 937 providers billing this code