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#62 of 11K

H0038

Self-help/peer services, per 15 minutes

Self-help/peer services, per 15 minutes is the #62 most-billed Medicaid procedure code, with $3.12B in payments across 30.4M claims from 2018–2024. The national median cost per claim is $55.04. Costs vary widely — the 90th percentile is $192.65 per claim, 3.5× the median.

Total Paid

$3.12B

0.29% of all spending

Total Claims

30.4M

Providers

4K

Avg Cost/Claim

$103

National Cost Distribution

How much do providers bill per claim for H0038? Based on 4K providers billing this code nationally.

Median

$55.04

Average

$114.99

Std Dev

$302.40

Max

$8,874.80

Percentile Distribution (Cost per Claim)

p10
$12.60
p25
$27.03
Median
$55.04
p75
$106.92
p90
$192.65
p95
$352.00
p99
$1,219.00

50% of providers bill between $27.03 and $106.92 per claim for this code.

90% bill between $12.60 and $192.65.

Top 1% bill above $1,219.00.

About This Procedure

HCPCS code H0038 (Self-help/peer services, per 15 minutes) was billed by 4K providers across 30.4M claims, totaling $3.12B in Medicaid payments from 2018–2024. This code was used for 6.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$55.04

Providers Billing

4K

National Spending

$3.12B

Avg/Median Ratio

2.09×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for H0038

#ProviderTotal Paid
1A Physicians Home Care

Colorado Springs, CO · In Home Supportive Care

$234.4M
2Personal Assistance Services Of Colorado Llc

Lakewood, CO · In Home Supportive Care

$135.1M
3A Circle Of Care Colorado Llc.

Colorado Springs, CO · In Home Supportive Care

$101.7M
4Premier Healthcare Services Llc

Grand Junction, CO · In Home Supportive Care

$79.8M
5Peoplecare Of Western Colorado Llc

Delta, CO · In Home Supportive Care

$43.7M
61306164975$40.6M
71578013017$40.6M
8Colorado Springs Independence Center

Colorado Springs, CO · Home Health

$39.8M
91114325347$36.2M
10County Of Riverside

Riverside, CA · Community/Behavioral Health

$30.5M
111427574433$29.3M
12Evergreen Home Healthcare Llc

Westminster, CO · In Home Supportive Care

$28.2M
131356919286$27.9M
14Estrella Home Health Care Inc.

Denver, CO · Home Health

$27.8M
15Addiction Recovery Care Llc

Louisa, KY · Community Based Residential Treatment Facility, Mental Illness

$27.3M
161740541952$22.9M
17Peoplecare Of Southern Colorado Llc

Pueblo, CO · In Home Supportive Care

$20.5M
181124646328$19.6M
191588113286$18.2M
201437575024$17.9M

Showing top 20 of 4K providers billing this code