#878 of 11K

A9999

HCPCS Procedure Code

HCPCS code A9999 is the #878 most-billed Medicaid procedure code, with $63.8M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $39.73. Costs vary widely — the 90th percentile is $203.42 per claim, 5.1× the median.

Total Paid

$63.8M

0.01% of all spending

Total Claims

1.1M

Providers

272

Avg Cost/Claim

$58

National Cost Distribution

How much do providers bill per claim for A9999? Based on 257 providers billing this code nationally.

Median

$39.73

Average

$113.30

Std Dev

$227.77

Max

$1,985.00

Percentile Distribution (Cost per Claim)

p10

$3.08

p25

$7.11

Median

$39.73

p75

$118.46

p90

$203.42

p95

$553.88

p99

$1,047.76

50% of providers bill between $7.11 and $118.46 per claim for this code.

90% bill between $3.08 and $203.42.

Top 1% bill above $1,047.76.

About This Procedure

HCPCS code A9999 was billed by 272 providers across 1.1M claims, totaling $63.8M in Medicaid payments from 2018–2024. This code was used for 548K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$39.73

Providers Billing

257

National Spending

$63.8M

Avg/Median Ratio

2.85×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for A9999

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1033596325	$7.4M	$793.43	20.0× median	Top 10%
2	1336736115	$6.1M	$18.32	0.5× median	Below Median
3	1902829500	$4.0M	$316.28	8.0× median	Top 10%
4	1992850689	$2.8M	$125.29	3.2× median	Above 75th
5	1932467743	$2.8M	$695.90	17.5× median	Top 10%
6	1962440891	$2.4M	$539.79	13.6× median	Top 10%
7	1316903545	$2.4M	$548.74	13.8× median	Top 10%
8	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$1.5M	$39.02	1.0× median	Below Median
9	1598306904	$1.5M	$574.43	14.5× median	Top 10%
10	1841400454	$1.3M	$1,573.99	39.6× median	Top 1%
11	J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies	$1.3M	$71.50	1.8× median	Above Median
12	1477112092	$1.2M	$812.22	20.4× median	Top 10%
13	1780625533	$1.1M	$27.03	0.7× median	Below Median
14	Rem Missouri Llc Saint Louis, MO · Clinic/Center Developmental Disabilities	$1.1M	$118.99	3.0× median	Above 75th
15	1770067837	$1.0M	$613.04	15.4× median	Top 10%
16	1649228909	$1.0M	$120.88	3.0× median	Above 75th
17	1861480048	$991K	$43.81	1.1× median	Above Median
18	Pediatric Home Respiratory Services Llc Roseville, MN · Home Health	$977K	$18.21	0.5× median	Below Median
19	1639770183	$973K	$90.11	2.3× median	Above Median
20	Total Longterm Care Inc. Aurora, CO · PACE Provider Organization	$869K	$141.66	3.6× median	Above 75th

Showing top 20 of 272 providers billing this code

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