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#634 of 11K

H0045

Respite care services, not in the home, per diem

Respite care services, not in the home, per diem is the #634 most-billed Medicaid procedure code, with $119.3M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $119.19. Costs vary widely — the 90th percentile is $491.14 per claim, 4.1× the median.

Total Paid

$119.3M

0.01% of all spending

Total Claims

1.0M

Providers

163

Avg Cost/Claim

$118

National Cost Distribution

How much do providers bill per claim for H0045? Based on 153 providers billing this code nationally.

Median

$119.19

Average

$302.28

Std Dev

$613.53

Max

$4,819.58

Percentile Distribution (Cost per Claim)

p10
$61.08
p25
$82.97
Median
$119.19
p75
$262.13
p90
$491.14
p95
$1,295.08
p99
$3,285.30

50% of providers bill between $82.97 and $262.13 per claim for this code.

90% bill between $61.08 and $491.14.

Top 1% bill above $3,285.30.

About This Procedure

HCPCS code H0045 (Respite care services, not in the home, per diem) was billed by 163 providers across 1.0M claims, totaling $119.3M in Medicaid payments from 2018–2024. This code was used for 148K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$119.19

Providers Billing

153

National Spending

$119.3M

Avg/Median Ratio

2.54×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for H0045

#ProviderTotal Paid
11881751865$8.1M
21770637407$6.1M
31790801819$5.6M
41316276975$5.2M
51497378764$4.6M
61174954572$4.1M
71992949796$3.6M
81871647503$2.9M
91669785614$2.9M
101477646081$2.9M
11Abound Health, Llc

Mint Hill, NC · In Home Supportive Care

$2.8M
121013061746$2.8M
131275677940$2.8M
14Abound Health Llc

Mint Hill, NC · Community/Behavioral Health

$2.4M
151942855887$2.4M
161821194531$2.3M
171912137050$2.2M
181558877407$2.2M
191346382975$1.9M
201164569802$1.7M

Showing top 20 of 163 providers billing this code