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#3218 of 11K

99494

HCPCS Procedure Code

HCPCS code 99494 is the #3,218 most-billed Medicaid procedure code, with $2.2M in payments across 70K claims from 2018–2024. The national median cost per claim is $36.93. Costs vary widely — the 90th percentile is $85.81 per claim, 2.3× the median.

Total Paid

$2.2M

0.00% of all spending

Total Claims

70K

Providers

131

Avg Cost/Claim

$32

National Cost Distribution

How much do providers bill per claim for 99494? Based on 114 providers billing this code nationally.

Median

$36.93

Average

$40.64

Std Dev

$32.61

Max

$188.68

Percentile Distribution (Cost per Claim)

p10
$2.98
p25
$15.05
Median
$36.93
p75
$55.99
p90
$85.81
p95
$96.03
p99
$128.44

50% of providers bill between $15.05 and $55.99 per claim for this code.

90% bill between $2.98 and $85.81.

Top 1% bill above $128.44.

About This Procedure

HCPCS code 99494 was billed by 131 providers across 70K claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 54K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$36.93

Providers Billing

114

National Spending

$2.2M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99494

#ProviderTotal Paid
11710336094$585K
21376014076$186K
31215205539$167K
41043376973$91K
51649538109$73K
61447643853$69K
71760407571$59K
8Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$57K
91548664840$54K
101477827418$52K
111417409905$52K
121669402848$44K
131407483175$43K
141801808357$43K
151366472326$39K
161225356157$39K
171912142985$34K
181770760407$27K
191750613329$26K
201780676650$25K

Showing top 20 of 131 providers billing this code