99255
HCPCS Procedure Code
HCPCS code 99255 is the #1,001 most-billed Medicaid procedure code, with $49.1M in payments across 435K claims from 2018–2024. The national median cost per claim is $90.45.
Total Paid
$49.1M
0.00% of all spending
Total Claims
435K
Providers
1K
Avg Cost/Claim
$113
National Cost Distribution
How much do providers bill per claim for 99255? Based on 1K providers billing this code nationally.
Median
$90.45
Average
$108.14
Std Dev
$72.85
Max
$1,985.70
Percentile Distribution (Cost per Claim)
50% of providers bill between $78.48 and $126.69 per claim for this code.
90% bill between $58.59 and $172.64.
Top 1% bill above $306.74.
About This Procedure
HCPCS code 99255 was billed by 1K providers across 435K claims, totaling $49.1M in Medicaid payments from 2018–2024. This code was used for 396K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$90.45
Providers Billing
1K
National Spending
$49.1M
Avg/Median Ratio
1.20×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99255
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1881068898 | $1.3M |
| 2 | County Of San Diego San Diego, CA · Public Health or Welfare | $1.2M |
| 3 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $1.1M |
| 4 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $927K |
| 5 | 1225105224 | $836K |
| 6 | 1811920549 | $716K |
| 7 | Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.) | $696K |
| 8 | 1215986468 | $621K |
| 9 | 1801874573 | $595K |
| 10 | 1609157197 | $580K |
| 11 | 1861442824 | $576K |
| 12 | 1265982375 | $544K |
| 13 | 1235125717 | $532K |
| 14 | 1225117328 | $525K |
| 15 | 1861409898 | $482K |
| 16 | 1356377576 | $472K |
| 17 | 1528541695 | $447K |
| 18 | 1740231448 | $446K |
| 19 | 1033271291 | $401K |
| 20 | 1649513573 | $397K |
Showing top 20 of 1K providers billing this code