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#2133 of 11K

M0117

HCPCS Procedure Code

HCPCS code M0117 is the #2,133 most-billed Medicaid procedure code, with $8.6M in payments across 196K claims from 2018–2024. The national median cost per claim is $47.85.

Total Paid

$8.6M

0.00% of all spending

Total Claims

196K

Providers

38

Avg Cost/Claim

$44

National Cost Distribution

How much do providers bill per claim for M0117? Based on 38 providers billing this code nationally.

Median

$47.85

Average

$47.42

Std Dev

$4.42

Max

$59.01

Percentile Distribution (Cost per Claim)

p10
$43.65
p25
$45.92
Median
$47.85
p75
$49.27
p90
$51.81
p95
$52.30
p99
$57.09

50% of providers bill between $45.92 and $49.27 per claim for this code.

90% bill between $43.65 and $51.81.

Top 1% bill above $57.09.

About This Procedure

HCPCS code M0117 was billed by 38 providers across 196K claims, totaling $8.6M in Medicaid payments from 2018–2024. This code was used for 9K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$47.85

Providers Billing

38

National Spending

$8.6M

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0117

#ProviderTotal Paid
1Daybreak Community Services Texas Llc

Fort Worth, TX · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities

$1.2M
2Berry Family Services

Rowlett, TX · Case Management

$913K
31336340157$447K
41134320294$362K
5Abiding Choice Inc

Rockdale, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$328K
61598084774$328K
7Wellness Healthcare Solutions Inc.

Desoto, TX · Day Training, Developmentally Disabled Services

$312K
8Kenmar Residential Hcs Services Inc.

Round Rock, TX · Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

$311K
91013261015$286K
10D&s Residential Services, Lp

Austin, TX · Intermediate Care Facility, Intellectual Disabilities

$265K
11Lifetime Living Inc.

San Antonio, TX · Case Management

$264K
121598974057$260K
131811039225$260K
141326252214$244K
151972700094$214K
161427259241$201K
171205037066$200K
181710014618$197K
191295944759$194K
201417156100$186K

Showing top 20 of 38 providers billing this code