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#26 of 11K

H0004

Behavioral health counseling & therapy, per 15 min

Behavioral health counseling & therapy, per 15 min is the #26 most-billed Medicaid procedure code, with $6.55B in payments across 73.3M claims from 2018–2024. The national median cost per claim is $74.63.

Total Paid

$6.55B

0.60% of all spending

Total Claims

73.3M

Providers

9K

Avg Cost/Claim

$89

National Cost Distribution

How much do providers bill per claim for H0004? Based on 8K providers billing this code nationally.

Median

$74.63

Average

$105.19

Std Dev

$286.34

Max

$11,798.98

Percentile Distribution (Cost per Claim)

p10
$28.71
p25
$52.54
Median
$74.63
p75
$101.63
p90
$143.38
p95
$212.51
p99
$617.08

50% of providers bill between $52.54 and $101.63 per claim for this code.

90% bill between $28.71 and $143.38.

Top 1% bill above $617.08.

About This Procedure

HCPCS code H0004 (Behavioral health counseling & therapy, per 15 min) was billed by 9K providers across 73.3M claims, totaling $6.55B in Medicaid payments from 2018–2024. This code was used for 27.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$74.63

Providers Billing

8K

National Spending

$6.55B

Avg/Median Ratio

1.41×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for H0004

#ProviderTotal Paid
1Los Angeles County Department Of Public Health

Alhambra, CA · Public Health or Welfare

$188.2M
2County Of San Diego

San Diego, CA · Public Health or Welfare

$90.9M
3Department Of Behavioral Health

Fresno, CA · Social Worker, Clinical

$53.0M
4County Of Sacramento

Sacramento, CA · Community/Behavioral Health

$52.5M
5County Of Kern

Bakersfield, CA · Clinic/Center, Adult Mental Health

$38.8M
61538122445$37.8M
71588840045$36.3M
8Alabama Department Of Mental Health And Mental Retardation

Montgomery, AL · Community/Behavioral Health

$35.7M
91336196401$35.2M
101932413556$35.1M
11A Better You Wellness Center, Llc

Phoenix, AZ · Community/Behavioral Health

$33.0M
12Bhpn Llc

Walnut Creek, CA · Case Management

$32.3M
131669897385$32.1M
14Southwest Behavioral Health Services Inc

Phoenix, AZ · Community/Behavioral Health

$30.8M
15State Of Missouri

Jefferson City, MO · Counselor, Addiction (Substance Use Disorder)

$30.8M
161073548640$30.3M
171891294021$28.8M
181801072590$28.6M
19County Of Riverside

Riverside, CA · Community/Behavioral Health

$28.4M
201609300854$28.0M

Showing top 20 of 9K providers billing this code