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#287 of 11K

H0047

Alcohol and/or drug abuse, not otherwise specified

Alcohol and/or drug abuse, not otherwise specified is the #287 most-billed Medicaid procedure code, with $494.1M in payments across 2.6M claims from 2018–2024. The national median cost per claim is $81.37. Costs vary widely — the 90th percentile is $413.26 per claim, 5.1× the median.

Total Paid

$494.1M

0.05% of all spending

Total Claims

2.6M

Providers

530

Avg Cost/Claim

$187

National Cost Distribution

How much do providers bill per claim for H0047? Based on 421 providers billing this code nationally.

Median

$81.37

Average

$153.32

Std Dev

$161.53

Max

$945.00

Percentile Distribution (Cost per Claim)

p10
$17.18
p25
$50.60
Median
$81.37
p75
$222.74
p90
$413.26
p95
$495.63
p99
$664.98

50% of providers bill between $50.60 and $222.74 per claim for this code.

90% bill between $17.18 and $413.26.

Top 1% bill above $664.98.

About This Procedure

HCPCS code H0047 (Alcohol and/or drug abuse, not otherwise specified) was billed by 530 providers across 2.6M claims, totaling $494.1M in Medicaid payments from 2018–2024. This code was used for 834K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$81.37

Providers Billing

421

National Spending

$494.1M

Avg/Median Ratio

1.88×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for H0047

#ProviderTotal Paid
1Recover Together Inc.

Greenfield, IN · Clinic/Center Adult Mental Health

$46.6M
21346604246$33.2M
31528427598$31.2M
41053478164$27.9M
51073972048$24.3M
61902325426$20.8M
71154594216$18.9M
81518503267$14.7M
91992281034$14.3M
101851513394$14.1M
111417316902$13.1M
121073841789$12.4M
131538385489$9.8M
141134575335$9.1M
151699329003$6.7M
161437273000$6.5M
17Spero Health Of Kentucky Llc

Danville, KY · Family Medicine Addiction Medicine

$5.4M
181174122766$5.0M
191184678559$4.8M
201912482787$4.6M

Showing top 20 of 530 providers billing this code