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#675 of 11K

97802

Medical nutrition therapy, reassessment, individual, fifteen minutes

Medical nutrition therapy, reassessment, individual, fifteen minutes is the #675 most-billed Medicaid procedure code, with $107.6M in payments across 8.4M claims from 2018–2024. The national median cost per claim is $12.70. Costs vary widely — the 90th percentile is $93.56 per claim, 7.4× the median.

Total Paid

$107.6M

0.01% of all spending

Total Claims

8.4M

Providers

5K

Avg Cost/Claim

$13

National Cost Distribution

How much do providers bill per claim for 97802? Based on 4K providers billing this code nationally.

Median

$12.70

Average

$32.40

Std Dev

$45.94

Max

$680.00

Percentile Distribution (Cost per Claim)

p10
$0.25
p25
$1.76
Median
$12.70
p75
$48.23
p90
$93.56
p95
$119.51
p99
$185.85

50% of providers bill between $1.76 and $48.23 per claim for this code.

90% bill between $0.25 and $93.56.

Top 1% bill above $185.85.

About This Procedure

HCPCS code 97802 (Medical nutrition therapy, reassessment, individual, fifteen minutes) was billed by 5K providers across 8.4M claims, totaling $107.6M in Medicaid payments from 2018–2024. This code was used for 7.7M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.70

Providers Billing

4K

National Spending

$107.6M

Avg/Median Ratio

2.55×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 97802

#ProviderTotal Paid
11851652739$2.2M
21003011602$1.4M
31700070935$1.3M
4Children's Hospital Corporation

Boston, MA · Clinic/Center

$1.1M
51588614192$955K
6Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$927K
7New York City Health And Hospitals Corporation

New York, NY · Internal Medicine

$772K
81598139883$744K
91770760530$740K
101174868897$739K
11Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$721K
121689066029$682K
131518747401$668K
141124141163$667K
15Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$657K
161003902610$608K
17The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$605K
18Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$565K
191023122967$555K
201881763068$547K

Showing top 20 of 5K providers billing this code