99309
Nursing facility care, subsequent, low complexity
Nursing facility care, subsequent, low complexity is the #202 most-billed Medicaid procedure code, with $781.4M in payments across 43.7M claims from 2018–2024. The national median cost per claim is $14.00. Costs vary widely — the 90th percentile is $39.72 per claim, 2.8× the median.
Total Paid
$781.4M
0.07% of all spending
Total Claims
43.7M
Providers
13K
Avg Cost/Claim
$18
National Cost Distribution
How much do providers bill per claim for 99309? Based on 13K providers billing this code nationally.
Median
$14.00
Average
$18.75
Std Dev
$18.28
Max
$560.39
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.16 and $24.83 per claim for this code.
90% bill between $3.44 and $39.72.
Top 1% bill above $77.99.
About This Procedure
HCPCS code 99309 (Nursing facility care, subsequent, low complexity) was billed by 13K providers across 43.7M claims, totaling $781.4M in Medicaid payments from 2018–2024. This code was used for 24.7M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$14.00
Providers Billing
13K
National Spending
$781.4M
Avg/Median Ratio
1.34×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99309
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1881109452 | $12.7M |
| 2 | 1578709515 | $8.2M |
| 3 | 1669422846 | $7.9M |
| 4 | 1114115706 | $6.9M |
| 5 | 1548759392 | $6.8M |
| 6 | Reliant Physicians (Kumar) Pllc Las Vegas, NV · Hospitalist | $6.4M |
| 7 | 1780056168 | $6.3M |
| 8 | Los Angeles County Department Of Mental Health Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center) | $5.4M |
| 9 | 1972912228 | $5.4M |
| 10 | 1700894466 | $5.0M |
| 11 | Maryland Medical First P.a. Baltimore, MD · Internal Medicine | $5.0M |
| 12 | 1124313309 | $4.9M |
| 13 | 1356853691 | $4.8M |
| 14 | 1073171849 | $4.6M |
| 15 | 1033861349 | $4.5M |
| 16 | 1609362375 | $4.3M |
| 17 | 1689799579 | $4.2M |
| 18 | 1518386739 | $4.1M |
| 19 | 1104277656 | $3.9M |
| 20 | 1073562922 | $3.9M |
Showing top 20 of 13K providers billing this code