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#1550 of 11K

99241

Office consultation, straightforward

Office consultation, straightforward is the #1,550 most-billed Medicaid procedure code, with $19.6M in payments across 296K claims from 2018–2024. The national median cost per claim is $36.49. Costs vary widely — the 90th percentile is $98.17 per claim, 2.7× the median.

Total Paid

$19.6M

0.00% of all spending

Total Claims

296K

Providers

555

Avg Cost/Claim

$66

National Cost Distribution

How much do providers bill per claim for 99241? Based on 508 providers billing this code nationally.

Median

$36.49

Average

$47.86

Std Dev

$40.28

Max

$595.51

Percentile Distribution (Cost per Claim)

p10
$14.46
p25
$26.80
Median
$36.49
p75
$58.12
p90
$98.17
p95
$105.40
p99
$149.77

50% of providers bill between $26.80 and $58.12 per claim for this code.

90% bill between $14.46 and $98.17.

Top 1% bill above $149.77.

About This Procedure

HCPCS code 99241 (Office consultation, straightforward) was billed by 555 providers across 296K claims, totaling $19.6M in Medicaid payments from 2018–2024. This code was used for 267K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$36.49

Providers Billing

508

National Spending

$19.6M

Avg/Median Ratio

1.31×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99241

#ProviderTotal Paid
11992746879$2.4M
2Yukon-kuskokwim Health Corporation

Bethel, AK · General Acute Care Hospital Rural

$1.0M
31275583726$764K
41275844789$636K
51669412441$614K
61043849086$602K
71528058864$545K
81063499101$513K
91043822208$502K
101871891168$489K
111205980927$455K
121063489482$412K
131215904800$410K
141205890332$356K
151689680449$336K
161528103488$305K
171649325614$283K
18State Of Missouri

Jefferson City, MO · Psychologist, Rehabilitation

$266K
191609862622$251K
201669617197$211K

Showing top 20 of 555 providers billing this code