Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#920 of 11K

H2026

HCPCS Procedure Code

HCPCS code H2026 is the #920 most-billed Medicaid procedure code, with $58.5M in payments across 771K claims from 2018–2024. The national median cost per claim is $76.18. Costs vary widely — the 90th percentile is $259.75 per claim, 3.4× the median.

Total Paid

$58.5M

0.01% of all spending

Total Claims

771K

Providers

116

Avg Cost/Claim

$76

National Cost Distribution

How much do providers bill per claim for H2026? Based on 108 providers billing this code nationally.

Median

$76.18

Average

$235.46

Std Dev

$768.57

Max

$5,888.76

Percentile Distribution (Cost per Claim)

p10
$41.07
p25
$56.05
Median
$76.18
p75
$122.94
p90
$259.75
p95
$502.59
p99
$4,974.70

50% of providers bill between $56.05 and $122.94 per claim for this code.

90% bill between $41.07 and $259.75.

Top 1% bill above $4,974.70.

About This Procedure

HCPCS code H2026 was billed by 116 providers across 771K claims, totaling $58.5M in Medicaid payments from 2018–2024. This code was used for 80K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$76.18

Providers Billing

108

National Spending

$58.5M

Avg/Median Ratio

3.09×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for H2026

#ProviderTotal Paid
11487778858$3.2M
21063845881$2.6M
3Babcock Center, Inc.

West Columbia, SC · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$2.5M
41588695191$2.4M
5Tri-development Center Of Aiken County, Inc.

Aiken, SC · Psychologist, Adult Development & Aging

$2.3M
6Clarendon County Dsn Board

Manning, SC · Early Intervention Provider Agency

$2.2M
7The Charles Lea Center Inc.

Spartanburg, SC · In Home Supportive Care

$2.1M
8Fard Health Services Llc

Phoenix, AZ · Clinic/Center, Mental Health (Including Community Mental Health Center)

$1.9M
91881718500$1.7M
101629408455$1.5M
111144366790$1.5M
12Chesco Services

Chesterfield, SC · Early Intervention Provider Agency

$1.5M
13Orangeburg Co. Dsn Board

Orangeburg, SC · Public Health or Welfare

$1.5M
141710188396$1.4M
15Greenville County Disabilities And Special Needs Board

Greenville, SC · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities

$1.3M
161902434236$1.2M
17Fairfield County Disabilities And Special Needs Board

Winnsboro, SC · Day Training, Developmentally Disabled Services

$1.1M
181063750941$1.0M
191992267066$986K
201235353210$978K

Showing top 20 of 116 providers billing this code