H2021
Community-based wrap-around services, per 15 min
Community-based wrap-around services, per 15 min is the #73 most-billed Medicaid procedure code, with $2.66B in payments across 14.3M claims from 2018–2024. The national median cost per claim is $169.11. Costs vary widely — the 90th percentile is $677.94 per claim, 4.0× the median.
Total Paid
$2.66B
0.24% of all spending
Total Claims
14.3M
Providers
1K
Avg Cost/Claim
$186
National Cost Distribution
How much do providers bill per claim for H2021? Based on 1K providers billing this code nationally.
Median
$169.11
Average
$308.32
Std Dev
$507.50
Max
$9,445.22
Percentile Distribution (Cost per Claim)
50% of providers bill between $94.76 and $335.58 per claim for this code.
90% bill between $47.22 and $677.94.
Top 1% bill above $2,183.14.
About This Procedure
HCPCS code H2021 (Community-based wrap-around services, per 15 min) was billed by 1K providers across 14.3M claims, totaling $2.66B in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.
Risk Assessment
This procedure is featured in our investigation: NY Home Care Machine
Read the full analysis for context on billing patterns associated with this code.
Billing Statistics
Median Cost/Claim
$169.11
Providers Billing
1K
National Spending
$2.66B
Avg/Median Ratio
1.82×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for H2021
| # | Provider | Total Paid |
|---|---|---|
| 1 | Public Partnerships Llc Latham, NY · Supports Brokerage | $343.1M |
| 2 | John F Murphy Homes Inc. Auburn, ME · Nursing Facility/Intermediate Care Facility | $108.6M |
| 3 | 1487982450 | $37.2M |
| 4 | Colorado Family Caregivers Llc Colorado Springs, CO · In Home Supportive Care | $36.8M |
| 5 | Alabama Department Of Mental Health And Mental Retardation Montgomery, AL · Community/Behavioral Health | $32.8M |
| 6 | 1740340132 | $32.2M |
| 7 | 1487113916 | $30.0M |
| 8 | 1679627863 | $26.9M |
| 9 | Tempo Management, Llc Kinnelon, NJ · Home Health | $26.7M |
| 10 | 1407220601 | $26.2M |
| 11 | 1902331416 | $24.3M |
| 12 | 1881832640 | $23.3M |
| 13 | 1184716573 | $22.7M |
| 14 | 1699011049 | $22.0M |
| 15 | 1053341859 | $21.4M |
| 16 | 1194859306 | $20.3M |
| 17 | 1821691254 | $19.3M |
| 18 | Los Angeles County Department Of Mental Health Los Angeles, CA · Clinic/Center, Mental Health (Including Community Mental Health Center) | $19.2M |
| 19 | 1174851042 | $18.9M |
| 20 | 1114159449 | $18.8M |
Showing top 20 of 1K providers billing this code