Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#191 of 11K

G0467

Federally qualified health center visit, mental health

Federally qualified health center visit, mental health is the #191 most-billed Medicaid procedure code, with $909.0M in payments across 19.7M claims from 2018–2024. The national median cost per claim is $21.91. Costs vary widely — the 90th percentile is $69.40 per claim, 3.2× the median.

Total Paid

$909.0M

0.08% of all spending

Total Claims

19.7M

Providers

5K

Avg Cost/Claim

$46

National Cost Distribution

How much do providers bill per claim for G0467? Based on 4K providers billing this code nationally.

Median

$21.91

Average

$35.30

Std Dev

$55.80

Max

$549.75

Percentile Distribution (Cost per Claim)

p10
$1.31
p25
$9.37
Median
$21.91
p75
$34.24
p90
$69.40
p95
$127.34
p99
$335.34

50% of providers bill between $9.37 and $34.24 per claim for this code.

90% bill between $1.31 and $69.40.

Top 1% bill above $335.34.

About This Procedure

HCPCS code G0467 (Federally qualified health center visit, mental health) was billed by 5K providers across 19.7M claims, totaling $909.0M in Medicaid payments from 2018–2024. This code was used for 15.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$21.91

Providers Billing

4K

National Spending

$909.0M

Avg/Median Ratio

1.61×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for G0467

#ProviderTotal Paid
11669479929$30.5M
21811065576$25.1M
31780784439$20.4M
41518945278$20.2M
5Unity Health Care Inc.

Washington, DC · Clinic/Center Federally Qualified Health Center (FQHC)

$16.0M
6Lake County Tribal Health Consortium Inc.

Lakeport, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$13.7M
71669530986$11.8M
81326055450$11.0M
91477721058$10.9M
101043373244$10.6M
111023560331$9.6M
121255331583$8.2M
13Greenville Rancheria

Red Bluff, CA · Clinic/Center Community Health

$8.1M
14Chapa-de Indian Health Program Inc.

Auburn, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$8.1M
151629066238$8.1M
161982614103$7.8M
171780702571$6.3M
181720152275$5.9M
191205004884$5.8M
20North East Medical Services

San Francisco, CA · Case Manager/Care Coordinator

$5.5M

Showing top 20 of 5K providers billing this code