98940
HCPCS Procedure Code
HCPCS code 98940 is the #719 most-billed Medicaid procedure code, with $97.8M in payments across 6.0M claims from 2018–2024. The national median cost per claim is $14.55.
Total Paid
$97.8M
0.01% of all spending
Total Claims
6.0M
Providers
4K
Avg Cost/Claim
$16
National Cost Distribution
How much do providers bill per claim for 98940? Based on 3K providers billing this code nationally.
Median
$14.55
Average
$17.49
Std Dev
$31.66
Max
$719.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.83 and $18.46 per claim for this code.
90% bill between $6.85 and $23.62.
Top 1% bill above $75.97.
About This Procedure
HCPCS code 98940 was billed by 4K providers across 6.0M claims, totaling $97.8M in Medicaid payments from 2018–2024. This code was used for 2.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$14.55
Providers Billing
3K
National Spending
$97.8M
Avg/Median Ratio
1.20×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 98940
| # | Provider | Total Paid |
|---|---|---|
| 1 | Lake County Tribal Health Consortium Inc. Lakeport, CA · Clinic/Center Federally Qualified Health Center (FQHC) | $5.3M |
| 2 | 1376949503 | $1.8M |
| 3 | 1003000969 | $1.5M |
| 4 | 1760480610 | $1.5M |
| 5 | 1588699151 | $1.3M |
| 6 | 1851576888 | $1.1M |
| 7 | 1558801829 | $970K |
| 8 | 1609281310 | $955K |
| 9 | 1326053166 | $764K |
| 10 | 1538508015 | $727K |
| 11 | 1548643000 | $715K |
| 12 | 1013556638 | $694K |
| 13 | La Maestra Family Clinic, Inc. San Diego, CA · Clinic/Center, Federally Qualified Health Center (FQHC) | $687K |
| 14 | 1083611156 | $613K |
| 15 | 1467504530 | $603K |
| 16 | 1851821565 | $585K |
| 17 | North East Medical Services San Francisco, CA · Case Manager/Care Coordinator | $514K |
| 18 | 1942310875 | $461K |
| 19 | 1245422534 | $405K |
| 20 | 1962505131 | $400K |
Showing top 20 of 4K providers billing this code