97151
Behavior identification assessment
Behavior identification assessment is the #524 most-billed Medicaid procedure code, with $166.3M in payments across 857K claims from 2018–2024. The national median cost per claim is $161.10. Costs vary widely — the 90th percentile is $353.75 per claim, 2.2× the median.
Total Paid
$166.3M
0.02% of all spending
Total Claims
857K
Providers
791
Avg Cost/Claim
$194
National Cost Distribution
How much do providers bill per claim for 97151? Based on 784 providers billing this code nationally.
Median
$161.10
Average
$210.28
Std Dev
$223.92
Max
$3,869.10
Percentile Distribution (Cost per Claim)
50% of providers bill between $112.08 and $235.88 per claim for this code.
90% bill between $77.96 and $353.75.
Top 1% bill above $982.29.
About This Procedure
HCPCS code 97151 (Behavior identification assessment) was billed by 791 providers across 857K claims, totaling $166.3M in Medicaid payments from 2018–2024. This code was used for 351K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$161.10
Providers Billing
784
National Spending
$166.3M
Avg/Median Ratio
1.31×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97151
| # | Provider | Total Paid |
|---|---|---|
| 1 | Behavior Interventions, Inc King Of Prussia, PA · Behavior Analyst | $6.7M |
| 2 | Brett Dinovi & Associates Pa Llc Bensalem, PA · Behavior Analyst | $5.7M |
| 3 | Centria Healthcare Llc Farmington Hills, MI · Home Health | $5.0M |
| 4 | 1760977649 | $4.7M |
| 5 | 1619949948 | $4.1M |
| 6 | Abs Utah P.c. Salt Lake City, UT · Community/Behavioral Health | $3.0M |
| 7 | 1194212282 | $2.9M |
| 8 | 1255706628 | $2.4M |
| 9 | 1043822208 | $2.2M |
| 10 | National Mentor Healthcare, Llc Broomall, PA · Community/Behavioral Health | $2.1M |
| 11 | Gateway Pediatric Therapy Llc Bingham Farms, MI · Behavior Analyst | $2.1M |
| 12 | Genesee Health System Flint, MI · Community/Behavioral Health | $2.1M |
| 13 | Comprehab Llc Gastonia, NC · Speech-Language Pathologist, | $2.1M |
| 14 | 1962765693 | $2.1M |
| 15 | 1104119619 | $2.0M |
| 16 | 1558841163 | $1.9M |
| 17 | 1609135748 | $1.8M |
| 18 | Easter Seals Southern California Inc Irvine, CA · Behavior Analyst | $1.8M |
| 19 | Children's Crisis Treatment Center Philadelphia, PA · Community/Behavioral Health | $1.8M |
| 20 | 1285992743 | $1.8M |
Showing top 20 of 791 providers billing this code