#3182 of 11K

A9901

HCPCS Procedure Code

HCPCS code A9901 is the #3,182 most-billed Medicaid procedure code, with $2.3M in payments across 599K claims from 2018–2024. The national median cost per claim is $5.31. Costs vary widely — the 90th percentile is $51.70 per claim, 9.7× the median.

Total Paid

$2.3M

0.00% of all spending

Total Claims

599K

Providers

112

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for A9901? Based on 88 providers billing this code nationally.

Median

$5.31

Average

$20.89

Std Dev

$54.31

Max

$450.95

Percentile Distribution (Cost per Claim)

p10

$1.88

p25

$2.67

Median

$5.31

p75

$14.56

p90

$51.70

p95

$89.96

p99

$171.69

50% of providers bill between $2.67 and $14.56 per claim for this code.

90% bill between $1.88 and $51.70.

Top 1% bill above $171.69.

About This Procedure

HCPCS code A9901 was billed by 112 providers across 599K claims, totaling $2.3M in Medicaid payments from 2018–2024. This code was used for 559K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.31

Providers Billing

National Spending

$2.3M

Avg/Median Ratio

3.93×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A9901

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1467467050	$298K	$2.80	0.5× median	Below Median
2	Home Medical Equipment Specialists Llc Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$247K	$5.03	0.9× median	Below Median
3	1417436775	$189K	$2.64	0.5× median	Below Median
4	1902863434	$188K	$2.67	0.5× median	Below Median
5	Option 1 Nutrition Solutions Llc Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition	$184K	$14.19	2.7× median	Above Median
6	1477676997	$110K	$68.86	13.0× median	Top 10%
7	1144254079	$82K	$6.83	1.3× median	Above Median
8	Old Colony Elderly Services, Inc. Brockton, MA · Case Management	$74K	$15.57	2.9× median	Above 75th
9	1629072665	$71K	$1.99	0.4× median	Below Median
10	1154479913	$68K	$5.31	1.0× median	Below Median
11	1215997853	$67K	$2.40	0.5× median	Below Median
12	1962426122	$48K	$2.55	0.5× median	Below Median
13	1700958857	$46K	$2.75	0.5× median	Below Median
14	1538201264	$43K	$2.78	0.5× median	Below Median
15	1386925568	$35K	$5.40	1.0× median	Above Median
16	1265418891	$34K	$81.95	15.4× median	Top 10%
17	1780667303	$29K	$2.63	0.5× median	Below Median
18	1497038848	$28K	$6.13	1.2× median	Above Median
19	1427153626	$26K	$2.40	0.5× median	Below Median
20	1942238514	$25K	$2.21	0.4× median	Below Median

Showing top 20 of 112 providers billing this code

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