97156
HCPCS Procedure Code
HCPCS code 97156 is the #564 most-billed Medicaid procedure code, with $145.5M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $88.65.
Total Paid
$145.5M
0.01% of all spending
Total Claims
1.6M
Providers
1K
Avg Cost/Claim
$90
National Cost Distribution
How much do providers bill per claim for 97156? Based on 1K providers billing this code nationally.
Median
$88.65
Average
$95.11
Std Dev
$44.33
Max
$518.19
Percentile Distribution (Cost per Claim)
50% of providers bill between $66.70 and $119.99 per claim for this code.
90% bill between $47.45 and $143.95.
Top 1% bill above $244.26.
About This Procedure
HCPCS code 97156 was billed by 1K providers across 1.6M claims, totaling $145.5M in Medicaid payments from 2018–2024. This code was used for 731K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$88.65
Providers Billing
1K
National Spending
$145.5M
Avg/Median Ratio
1.07×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97156
| # | Provider | Total Paid |
|---|---|---|
| 1 | Centria Healthcare Llc Farmington Hills, MI · Home Health | $5.1M |
| 2 | 1255706628 | $4.0M |
| 3 | 1609135748 | $2.6M |
| 4 | Behavior Interventions, Inc King Of Prussia, PA · Behavior Analyst | $2.6M |
| 5 | 1558841163 | $2.5M |
| 6 | 1619949948 | $2.1M |
| 7 | 1588300131 | $1.8M |
| 8 | Positive Behavior Supports Stuart, FL · Community/Behavioral Health | $1.7M |
| 9 | 1295783066 | $1.7M |
| 10 | 1437290129 | $1.4M |
| 11 | Abs Utah P.c. Salt Lake City, UT · Community/Behavioral Health | $1.4M |
| 12 | 1053772939 | $1.3M |
| 13 | 1801289020 | $1.3M |
| 14 | Gateway Pediatric Therapy Llc Bingham Farms, MI · Behavior Analyst | $1.3M |
| 15 | 1285992743 | $1.2M |
| 16 | Comprehab Llc Gastonia, NC · Speech-Language Pathologist, | $1.1M |
| 17 | 1225187933 | $1.1M |
| 18 | 1922451657 | $1.0M |
| 19 | 1235449661 | $994K |
| 20 | 1750845327 | $982K |
Showing top 20 of 1K providers billing this code