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#2496 of 11K

G0159

Services of clinical social worker in home health, per 15 min

Services of clinical social worker in home health, per 15 min is the #2,496 most-billed Medicaid procedure code, with $5.3M in payments across 60K claims from 2018–2024. The national median cost per claim is $60.00.

Total Paid

$5.3M

0.00% of all spending

Total Claims

60K

Providers

85

Avg Cost/Claim

$89

National Cost Distribution

How much do providers bill per claim for G0159? Based on 17 providers billing this code nationally.

Median

$60.00

Average

$71.31

Std Dev

$41.67

Max

$139.00

Percentile Distribution (Cost per Claim)

p10
$23.21
p25
$34.63
Median
$60.00
p75
$103.85
p90
$118.75
p95
$123.24
p99
$135.85

50% of providers bill between $34.63 and $103.85 per claim for this code.

90% bill between $23.21 and $118.75.

Top 1% bill above $135.85.

About This Procedure

HCPCS code G0159 (Services of clinical social worker in home health, per 15 min) was billed by 85 providers across 60K claims, totaling $5.3M in Medicaid payments from 2018–2024. This code was used for 19K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$60.00

Providers Billing

17

National Spending

$5.3M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for G0159

#ProviderTotal Paid
11457772535$5.1M
21356343396$82K
31518969617$23K
41326259177$21K
51083797880$16K
6El Mirador Incorporated

Albuquerque, NM · Home Health

$12K
71639401011$11K
81649203431$6K
91205980240$6K
101346580610$5K
111508267444$5K
121801891023$5K
131346540580$5K
141194099127$4K
151568834653$3K
161407830706$661
171306384672$305
181508809526$0
191992144042$0
201538725585$0

Showing top 20 of 85 providers billing this code