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#542 of 11K

H0012

HCPCS Procedure Code

HCPCS code H0012 is the #542 most-billed Medicaid procedure code, with $156.8M in payments across 588K claims from 2018–2024. The national median cost per claim is $295.95. Costs vary widely — the 90th percentile is $621.79 per claim, 2.1× the median.

Total Paid

$156.8M

0.01% of all spending

Total Claims

588K

Providers

100

Avg Cost/Claim

$267

National Cost Distribution

How much do providers bill per claim for H0012? Based on 98 providers billing this code nationally.

Median

$295.95

Average

$345.15

Std Dev

$312.24

Max

$2,192.00

Percentile Distribution (Cost per Claim)

p10
$117.30
p25
$162.30
Median
$295.95
p75
$384.05
p90
$621.79
p95
$811.55
p99
$1,858.97

50% of providers bill between $162.30 and $384.05 per claim for this code.

90% bill between $117.30 and $621.79.

Top 1% bill above $1,858.97.

About This Procedure

HCPCS code H0012 was billed by 100 providers across 588K claims, totaling $156.8M in Medicaid payments from 2018–2024. This code was used for 133K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$295.95

Providers Billing

98

National Spending

$156.8M

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for H0012

#ProviderTotal Paid
1Los Angeles County Department Of Public Health

Alhambra, CA · Public Health or Welfare

$35.1M
21548367881$15.7M
3County Of San Diego

San Diego, CA · Public Health or Welfare

$14.5M
4City & County Of San Francisco

San Francisco, CA · Community/Behavioral Health

$9.2M
5County Of Riverside

Riverside, CA · Community/Behavioral Health

$8.8M
6County Of Orange

Santa Ana, CA · Clinic/Center Mental Health (Including Community Mental Health Center)

$5.6M
71821126004$5.1M
8County Of Santa Clara

San Jose, CA · Clinic/Center Methadone Clinic

$4.4M
91922368166$4.4M
10County Of San Bernardino

San Bernardino, CA · Clinic/Center Rehabilitation Substance Use Disorder

$4.3M
111881658276$4.1M
121912116252$3.7M
13County Of Santa Cruz

Santa Cruz, CA · Clinic/Center

$3.7M
14Contra Costa County

Martinez, CA · General Acute Care Hospital

$3.0M
15Alameda County Behavioral Health Care

Oakland, CA · Community/Behavioral Health

$3.0M
16County Of Ventura

Oxnard, CA · Community/Behavioral Health

$2.8M
171205022159$2.7M
181336370196$2.4M
191306862461$1.7M
20San Mateo County

San Mateo, CA · Community/Behavioral Health

$1.6M

Showing top 20 of 100 providers billing this code