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#526 of 11K

M0123

HCPCS Procedure Code

HCPCS code M0123 is the #526 most-billed Medicaid procedure code, with $165.4M in payments across 2.2M claims from 2018–2024. The national median cost per claim is $76.14.

Total Paid

$165.4M

0.02% of all spending

Total Claims

2.2M

Providers

192

Avg Cost/Claim

$76

National Cost Distribution

How much do providers bill per claim for M0123? Based on 192 providers billing this code nationally.

Median

$76.14

Average

$76.14

Std Dev

$0.02

Max

$76.14

Percentile Distribution (Cost per Claim)

p10
$76.14
p25
$76.14
Median
$76.14
p75
$76.14
p90
$76.14
p95
$76.14
p99
$76.14

50% of providers bill between $76.14 and $76.14 per claim for this code.

90% bill between $76.14 and $76.14.

Top 1% bill above $76.14.

About This Procedure

HCPCS code M0123 was billed by 192 providers across 2.2M claims, totaling $165.4M in Medicaid payments from 2018–2024. This code was used for 85K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$76.14

Providers Billing

192

National Spending

$165.4M

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0123

#ProviderTotal Paid
1Berry Family Services

Rowlett, TX · Case Management

$8.9M
2Daybreak Community Services Texas Llc

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

$8.6M
3Lifetime Living Inc.

San Antonio, TX · Case Management

$6.3M
4Wellness Healthcare Solutions Inc.

Desoto, TX · Day Training, Developmentally Disabled Services

$2.9M
5Advantage Behavioral Services, Inc.

San Antonio, TX · Case Management

$2.8M
61598084774$2.7M
7Texana Center

Rosenberg, TX · Counselor, Mental Health

$2.6M
81790860666$2.5M
91326252214$2.5M
101871794933$2.3M
11D&s Residential Services, Lp

Austin, TX · Intermediate Care Facility, Intellectual Disabilities

$2.3M
12Kenmar Residential Hcs Services Inc.

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

$2.0M
131811039225$2.0M
14St. Giles Living Centers, Inc.

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

$1.9M
15Abiding Choice Inc

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

$1.9M
161659558856$1.8M
171801962295$1.7M
181598974057$1.6M
191558400333$1.6M
201013297704$1.6M

Showing top 20 of 192 providers billing this code