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#451 of 11K

H1000

Prenatal care, at-risk assessment

Prenatal care, at-risk assessment is the #451 most-billed Medicaid procedure code, with $217.0M in payments across 3.8M claims from 2018–2024. The national median cost per claim is $50.36. Costs vary widely — the 90th percentile is $106.60 per claim, 2.1× the median.

Total Paid

$217.0M

0.02% of all spending

Total Claims

3.8M

Providers

1K

Avg Cost/Claim

$57

National Cost Distribution

How much do providers bill per claim for H1000? Based on 1K providers billing this code nationally.

Median

$50.36

Average

$56.54

Std Dev

$38.96

Max

$233.67

Percentile Distribution (Cost per Claim)

p10
$14.01
p25
$32.31
Median
$50.36
p75
$72.57
p90
$106.60
p95
$141.29
p99
$182.77

50% of providers bill between $32.31 and $72.57 per claim for this code.

90% bill between $14.01 and $106.60.

Top 1% bill above $182.77.

About This Procedure

HCPCS code H1000 (Prenatal care, at-risk assessment) was billed by 1K providers across 3.8M claims, totaling $217.0M in Medicaid payments from 2018–2024. This code was used for 2.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$50.36

Providers Billing

1K

National Spending

$217.0M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for H1000

#ProviderTotal Paid
11386823243$15.4M
21013902923$10.2M
31134189103$9.1M
41700990108$6.5M
51669429577$5.2M
61134214380$3.3M
71396732541$3.2M
81386751907$3.1M
91174955256$3.1M
101023055944$2.8M
111144276452$2.7M
121225034234$2.3M
131114025749$2.1M
141144252438$2.0M
151538360425$2.0M
161891116497$1.9M
171922210517$1.9M
181275829970$1.9M
191558750281$1.8M
201003280546$1.8M

Showing top 20 of 1K providers billing this code