#143 of 11K

H2018

Psychosocial rehabilitation services, per diem

Psychosocial rehabilitation services, per diem is the #143 most-billed Medicaid procedure code, with $1.28B in payments across 4.3M claims from 2018–2024. The national median cost per claim is $392.63. Costs vary widely — the 90th percentile is $2,831.11 per claim, 7.2× the median.

Total Paid

$1.28B

0.12% of all spending

Total Claims

4.3M

Providers

293

Avg Cost/Claim

$301

National Cost Distribution

How much do providers bill per claim for H2018? Based on 271 providers billing this code nationally.

Median

$392.63

Average

$747.65

Std Dev

$1,076.62

Max

$5,403.37

Percentile Distribution (Cost per Claim)

p10

$63.09

p25

$134.60

Median

$392.63

p75

$662.20

p90

$2,831.11

p95

$3,333.87

p99

$4,744.26

50% of providers bill between $134.60 and $662.20 per claim for this code.

90% bill between $63.09 and $2,831.11.

Top 1% bill above $4,744.26.

About This Procedure

HCPCS code H2018 (Psychosocial rehabilitation services, per diem) was billed by 293 providers across 4.3M claims, totaling $1.28B in Medicaid payments from 2018–2024. This code was used for 768K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$392.63

Providers Billing

271

National Spending

$1.28B

Avg/Median Ratio

1.90×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for H2018

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Commonwealth Of Massachusetts Tewksbury, MA · Community/Behavioral Health	$199.1M	$304.01	0.8× median	Below Median
2	Commonwealth Of Massachusetts-dmh Brockton, MA · Community/Behavioral Health	$193.1M	$365.55	0.9× median	Below Median
3	Department Of Mental Health Worcester, MA · Community/Behavioral Health	$156.3M	$259.62	0.7× median	Below Median
4	Commonwealth Of Massachusetts Boston, MA · Community/Behavioral Health	$148.2M	$337.76	0.9× median	Below Median
5	Department Of Mental Health Northampton, MA · Community/Behavioral Health	$142.5M	$404.03	1.0× median	Above Median
6	1851713614	$23.2M	$1,719.77	4.4× median	Above 75th
7	1588815302	$22.2M	$3,227.39	8.2× median	Top 10%
8	1538294699	$21.4M	$4,130.66	10.5× median	Top 10%
9	1740329531	$16.5M	$4,519.49	11.5× median	Top 10%
10	1992898670	$15.0M	$4,651.55	11.8× median	Top 10%
11	1215122361	$14.9M	$1,439.85	3.7× median	Above 75th
12	1336196401	$14.5M	$127.77	0.3× median	Below Median
13	1477695021	$13.1M	$3,048.09	7.8× median	Top 10%
14	1700085719	$13.1M	$3,585.07	9.1× median	Top 10%
15	1649333485	$12.2M	$3,108.54	7.9× median	Top 10%
16	1043759871	$12.1M	$281.56	0.7× median	Below Median
17	1992702955	$10.9M	$199.68	0.5× median	Below Median
18	1831409200	$10.5M	$2,981.16	7.6× median	Top 10%
19	1801945365	$9.6M	$3,683.52	9.4× median	Top 10%
20	1659330173	$8.4M	$4,221.65	10.8× median	Top 10%

Showing top 20 of 293 providers billing this code

Related Procedures

H2016Comprehensive community support services, per 15 min$19.75B H2015Comprehensive community support services, per 15 min$16.47B H2017Psychosocial rehabilitation services, per 15 min$8.54B H2019Therapeutic behavioral services, per 15 min$7.47B H2014Skills training & development, per 15 min$6.76B

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