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#1394 of 11K

99236

Observation care same day admit and discharge

Observation care same day admit and discharge is the #1,394 most-billed Medicaid procedure code, with $24.7M in payments across 173K claims from 2018–2024. The national median cost per claim is $128.23.

Total Paid

$24.7M

0.00% of all spending

Total Claims

173K

Providers

486

Avg Cost/Claim

$143

National Cost Distribution

How much do providers bill per claim for 99236? Based on 477 providers billing this code nationally.

Median

$128.23

Average

$132.99

Std Dev

$112.81

Max

$2,310.14

Percentile Distribution (Cost per Claim)

p10
$64.36
p25
$100.36
Median
$128.23
p75
$158.35
p90
$188.73
p95
$203.50
p99
$277.27

50% of providers bill between $100.36 and $158.35 per claim for this code.

90% bill between $64.36 and $188.73.

Top 1% bill above $277.27.

About This Procedure

HCPCS code 99236 (Observation care same day admit and discharge) was billed by 486 providers across 173K claims, totaling $24.7M in Medicaid payments from 2018–2024. This code was used for 157K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$128.23

Providers Billing

477

National Spending

$24.7M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99236

#ProviderTotal Paid
11760095806$2.7M
2Rwjbh Emergency Medicine Associates, Llc

Somerset, NJ · Nurse Practitioner, Primary Care

$1.7M
31861432130$1.0M
41073854766$877K
51497920524$774K
61124058508$673K
71447231865$480K
81811920549$462K
91801352505$444K
10Los Angeles County Department Of Mental Health

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

$430K
111275568479$319K
121619479870$313K
131780791343$306K
141538104476$293K
151972758134$268K
161700999471$261K
171154355931$261K
181033136841$258K
191346586658$252K
201194084111$245K

Showing top 20 of 486 providers billing this code