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#2289 of 11K

98967

HCPCS Procedure Code

HCPCS code 98967 is the #2,289 most-billed Medicaid procedure code, with $7.1M in payments across 348K claims from 2018–2024. The national median cost per claim is $18.97. Costs vary widely — the 90th percentile is $60.10 per claim, 3.2× the median.

Total Paid

$7.1M

0.00% of all spending

Total Claims

348K

Providers

733

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for 98967? Based on 594 providers billing this code nationally.

Median

$18.97

Average

$28.55

Std Dev

$37.26

Max

$378.99

Percentile Distribution (Cost per Claim)

p10
$0.61
p25
$6.63
Median
$18.97
p75
$37.07
p90
$60.10
p95
$100.74
p99
$170.35

50% of providers bill between $6.63 and $37.07 per claim for this code.

90% bill between $0.61 and $60.10.

Top 1% bill above $170.35.

About This Procedure

HCPCS code 98967 was billed by 733 providers across 348K claims, totaling $7.1M in Medicaid payments from 2018–2024. This code was used for 241K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$18.97

Providers Billing

594

National Spending

$7.1M

Avg/Median Ratio

1.51×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 98967

#ProviderTotal Paid
1Waianae District Comprehensive Health And Hospital Board, Inc

Waianae, HI · Pediatrics

$1.2M
2Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$1.0M
3Los Angeles County Department Of Mental Health

Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center)

$880K
41992730956$374K
51316040249$194K
6Community Health Center Inc

Middletown, CT · Counselor, Addiction (Substance Use Disorder)

$183K
7Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$151K
81306387949$124K
9Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$108K
101821059486$107K
111013946854$85K
12Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$83K
131710049218$79K
141346251782$64K
15The Hospital Of Central Connecticut At New Britain General And Bradley

New Britain, CT · General Acute Care Hospital

$56K
161467678706$54K
171841362795$53K
181740717743$49K
191396750840$46K
201215979810$40K

Showing top 20 of 733 providers billing this code