#1681 of 11K

H0049

HCPCS Procedure Code

HCPCS code H0049 is the #1,681 most-billed Medicaid procedure code, with $16.2M in payments across 2.6M claims from 2018–2024. The national median cost per claim is $9.27. Costs vary widely — the 90th percentile is $40.78 per claim, 4.4× the median.

Total Paid

$16.2M

0.00% of all spending

Total Claims

2.6M

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for H0049? Based on 1K providers billing this code nationally.

Median

$9.27

Average

$17.60

Std Dev

$36.06

Max

$479.50

Percentile Distribution (Cost per Claim)

p10

$0.31

p25

$2.54

Median

$9.27

p75

$20.05

p90

$40.78

p95

$51.76

p99

$155.28

50% of providers bill between $2.54 and $20.05 per claim for this code.

90% bill between $0.31 and $40.78.

Top 1% bill above $155.28.

About This Procedure

HCPCS code H0049 was billed by 2K providers across 2.6M claims, totaling $16.2M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$9.27

Providers Billing

National Spending

$16.2M

Avg/Median Ratio

1.90×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for H0049

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1932199171	$1.6M	$155.30	16.8× median	Top 1%
2	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$436K	$29.07	3.1× median	Above 75th
3	New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine	$389K	$51.41	5.5× median	Top 10%
4	1457568164	$316K	$90.69	9.8× median	Top 10%
5	1801345285	$304K	$19.61	2.1× median	Above Median
6	1194254219	$261K	$15.97	1.7× median	Above Median
7	1124648316	$255K	$48.03	5.2× median	Top 10%
8	1386926004	$254K	$49.95	5.4× median	Top 10%
9	Montefiore Medical Center Bronx, NY · Anesthesiology	$237K	$19.24	2.1× median	Above Median
10	1447464136	$216K	$114.98	12.4× median	Top 10%
11	1225254881	$214K	$42.66	4.6× median	Top 10%
12	1548373921	$209K	$45.43	4.9× median	Top 10%
13	County Of Sacramento Sacramento, CA · Community/Behavioral Health	$204K	$168.59	18.2× median	Top 1%
14	1699827345	$202K	$56.40	6.1× median	Top 10%
15	1205429800	$201K	$14.99	1.6× median	Above Median
16	Alameda County Behavioral Health Care Oakland, CA · Community/Behavioral Health	$192K	$96.37	10.4× median	Top 10%
17	1487185153	$187K	$16.44	1.8× median	Above Median
18	1568413524	$175K	$19.66	2.1× median	Above Median
19	1003824293	$174K	$13.20	1.4× median	Above Median
20	County Of Orange Santa Ana, CA · Clinic/Center Mental Health (Including Community Mental Health Center)	$173K	$210.84	22.7× median	Top 1%

Showing top 20 of 2K providers billing this code

Related Procedures

H0044Supported housing, per diem$2.98B H0040Assertive community treatment, face-to-face, per 15 minutes$2.57B H0046Mental health services, not otherwise specified$2.05B H0043Supported housing, per diem$1.89B H0039Assertive community treatment, per diem$1.70B

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