99509
Home visit, assistance w/ ADLs
Home visit, assistance w/ ADLs is the #33 most-billed Medicaid procedure code, with $5.57B in payments across 79.7M claims from 2018–2024. The national median cost per claim is $51.71. Costs vary widely — the 90th percentile is $126.85 per claim, 2.5× the median.
Total Paid
$5.57B
0.51% of all spending
Total Claims
79.7M
Providers
2K
Avg Cost/Claim
$70
National Cost Distribution
How much do providers bill per claim for 99509? Based on 2K providers billing this code nationally.
Median
$51.71
Average
$86.25
Std Dev
$161.03
Max
$3,287.82
Percentile Distribution (Cost per Claim)
50% of providers bill between $44.67 and $65.04 per claim for this code.
90% bill between $39.17 and $126.85.
Top 1% bill above $666.05.
About This Procedure
HCPCS code 99509 (Home visit, assistance w/ ADLs) was billed by 2K providers across 79.7M claims, totaling $5.57B in Medicaid payments from 2018–2024. This code was used for 5.3M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$51.71
Providers Billing
2K
National Spending
$5.57B
Avg/Median Ratio
1.67×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 99509
| # | Provider | Total Paid |
|---|---|---|
| 1 | Tempus Unlimited, Inc. Stoughton, MA · Voluntary or Charitable | $276.1M |
| 2 | Ambercare Home Health Care Corporation Albuquerque, NM · Home Health | $248.3M |
| 3 | Palco, Inc. Maumelle, AR · Supports Brokerage | $158.7M |
| 4 | New Mexico Consumer Direct Personal Care Llc Albuquerque, NM · Home Health | $127.5M |
| 5 | El Mirador Incorporated Albuquerque, NM · Home Health | $66.3M |
| 6 | Tempus Unlimited, Inc. Stoughton, MA · Voluntary or Charitable | $53.4M |
| 7 | At-home Personal Care Services Llc. Santa Teresa, NM · Home Health | $51.7M |
| 8 | 1023473329 | $50.5M |
| 9 | Heritage Home Healthcare Services Inc. Albuquerque, NM · Home Health | $48.8M |
| 10 | 1st Care Of New Mexico Llc Albuquerque, NM · In Home Supportive Care | $46.3M |
| 11 | Independent Living Resource Center Albuquerque, NM · Technician Personal Care Attendant | $46.0M |
| 12 | Inteli-care Llc Albuquerque, NM · Home Health | $43.7M |
| 13 | 1588085633 | $43.0M |
| 14 | 1053443341 | $40.2M |
| 15 | 1619011889 | $37.7M |
| 16 | 1568534055 | $37.5M |
| 17 | 1770624348 | $34.1M |
| 18 | 1346615523 | $32.2M |
| 19 | 1013272707 | $32.2M |
| 20 | 1740670942 | $30.3M |
Showing top 20 of 2K providers billing this code