M0116
HCPCS Procedure Code
HCPCS code M0116 is the #906 most-billed Medicaid procedure code, with $60.2M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $32.07.
Total Paid
$60.2M
0.01% of all spending
Total Claims
2.0M
Providers
240
Avg Cost/Claim
$30
National Cost Distribution
How much do providers bill per claim for M0116? Based on 240 providers billing this code nationally.
Median
$32.07
Average
$32.07
Std Dev
$2.73
Max
$40.14
Percentile Distribution (Cost per Claim)
50% of providers bill between $31.18 and $33.49 per claim for this code.
90% bill between $29.62 and $34.38.
Top 1% bill above $38.10.
About This Procedure
HCPCS code M0116 was billed by 240 providers across 2.0M claims, totaling $60.2M in Medicaid payments from 2018–2024. This code was used for 100K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$32.07
Providers Billing
240
National Spending
$60.2M
Avg/Median Ratio
1.00×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for M0116
| # | Provider | Total Paid |
|---|---|---|
| 1 | Daybreak Community Services Texas Llc Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $5.3M |
| 2 | Berry Family Services Rowlett, TX · Case Management | $1.6M |
| 3 | Rock House Support Services, Inc. Stephenville, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $1.5M |
| 4 | 1871794933 | $1.5M |
| 5 | D&s Residential Services, Lp Austin, TX · Intermediate Care Facility, Intellectual Disabilities | $1.4M |
| 6 | St. Giles Living Centers, Inc. Fort Worth, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $1.2M |
| 7 | Wellness Healthcare Solutions Inc. Desoto, TX · Day Training, Developmentally Disabled Services | $965K |
| 8 | 1598974057 | $876K |
| 9 | 1427259241 | $828K |
| 10 | 1396954855 | $807K |
| 11 | Texana Center Rosenberg, TX · Counselor, Mental Health | $761K |
| 12 | 1871704544 | $736K |
| 13 | Lifetime Living Inc. San Antonio, TX · Case Management | $722K |
| 14 | Kenmar Residential Hcs Services Inc. Round Rock, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $686K |
| 15 | 1295944759 | $676K |
| 16 | Advantage Behavioral Services, Inc. San Antonio, TX · Case Management | $634K |
| 17 | 1326252214 | $562K |
| 18 | 1801962295 | $541K |
| 19 | 1790860666 | $510K |
| 20 | 1891823381 | $500K |
Showing top 20 of 240 providers billing this code