H2016
Comprehensive community support services, per 15 min
Comprehensive community support services, per 15 min is the #8 most-billed Medicaid procedure code, with $19.75B in payments across 60.7M claims from 2018–2024. The national median cost per claim is $321.53. Costs vary widely — the 90th percentile is $2,592.98 per claim, 8.1× the median.
Total Paid
$19.75B
1.81% of all spending
Total Claims
60.7M
Providers
2K
Avg Cost/Claim
$325
National Cost Distribution
How much do providers bill per claim for H2016? Based on 2K providers billing this code nationally.
Median
$321.53
Average
$886.45
Std Dev
$1,563.77
Max
$17,250.25
Percentile Distribution (Cost per Claim)
50% of providers bill between $157.38 and $842.52 per claim for this code.
90% bill between $79.58 and $2,592.98.
Top 1% bill above $7,824.44.
About This Procedure
HCPCS code H2016 (Comprehensive community support services, per 15 min) was billed by 2K providers across 60.7M claims, totaling $19.75B in Medicaid payments from 2018–2024. This code was used for 4.2M unique beneficiaries.
Investigation Context
Comprehensive community support per diem (H2016) covers a full day of community-based behavioral health services. Per diem billing for community support has been flagged by investigators as an area with limited verification mechanisms.
Risk Assessment
Billing Statistics
Median Cost/Claim
$321.53
Providers Billing
2K
National Spending
$19.75B
Avg/Median Ratio
2.76×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for H2016
| # | Provider | Total Paid |
|---|---|---|
| 1 | Bancroft A New Jersey Nonprofit Corporation Cherry Hill, NJ · Clinic/Center Rehabilitation | $416.4M |
| 2 | The Devereux Foundation Cherry Hill, NJ · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $344.3M |
| 3 | Allies, Inc. Hamilton, NJ · Day Training, Developmentally Disabled Services | $343.9M |
| 4 | Community Options, Inc. Princeton, NJ · Day Training, Developmentally Disabled Services | $335.6M |
| 5 | Community Access Unlimited Elizabeth, NJ · Supports Brokerage | $319.1M |
| 6 | Public Partnerships Llc Latham, NY · Supports Brokerage | $315.5M |
| 7 | Caringhouse Projects Atlantic City, NJ · Respite Care | $265.8M |
| 8 | Beacon Specialized Living Services Inc. Bangor, MI · Residential Treatment Facility Intellectual and/or Developmental Disabilities | $225.7M |
| 9 | New Jersey Division Of Developmental Disabilities Hamilton, NJ · Day Training Developmentally Disabled Services | $215.2M |
| 10 | Rem New Jersey, Inc. Somerset, NJ · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $196.4M |
| 11 | Elwyn New Jersey Vineland, NJ · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $182.3M |
| 12 | Eihab Human Services New Jersey, Inc. Howell, NJ · Case Management | $169.5M |
| 13 | Rescare, Inc Fairfield, IA · Community/Behavioral Health | $162.6M |
| 14 | Mosaic Urbandale, IA · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $151.9M |
| 15 | Systems Unlimited Inc. Iowa City, IA · Day Training Developmentally Disabled Services | $146.6M |
| 16 | Eden Autism Services. Princeton, NJ · Day Training, Developmentally Disabled Services | $139.6M |
| 17 | Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $133.3M |
| 18 | Oaks Integrated Care, Inc Lumberton, NJ · Clinic/Center, Developmental Disabilities | $131.8M |
| 19 | Heart To Heart Health Care Services, Llc East Orange, NJ · Home Health | $131.8M |
| 20 | Spectrum For Living Development, Inc. River Vale, NJ · Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | $130.2M |
Showing top 20 of 2K providers billing this code