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#972 of 11K

M0152

HCPCS Procedure Code

HCPCS code M0152 is the #972 most-billed Medicaid procedure code, with $52.4M in payments across 310K claims from 2018–2024. The national median cost per claim is $174.64.

Total Paid

$52.4M

0.00% of all spending

Total Claims

310K

Providers

41

Avg Cost/Claim

$169

National Cost Distribution

How much do providers bill per claim for M0152? Based on 41 providers billing this code nationally.

Median

$174.64

Average

$170.40

Std Dev

$17.41

Max

$183.64

Percentile Distribution (Cost per Claim)

p10
$165.73
p25
$169.49
Median
$174.64
p75
$175.23
p90
$175.91
p95
$177.81
p99
$181.97

50% of providers bill between $169.49 and $175.23 per claim for this code.

90% bill between $165.73 and $175.91.

Top 1% bill above $181.97.

About This Procedure

HCPCS code M0152 was billed by 41 providers across 310K claims, totaling $52.4M in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$174.64

Providers Billing

41

National Spending

$52.4M

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0152

#ProviderTotal Paid
1Daybreak Community Services Texas Llc

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

$9.8M
2D&s Residential Services, Lp

Austin, TX · Intermediate Care Facility, Intellectual Disabilities

$4.3M
3Rock House Support Services, Inc.

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

$3.3M
4St. Giles Living Centers, Inc.

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

$2.6M
51871794933$2.1M
61972700094$2.0M
71427259241$2.0M
8Kenmar Residential Hcs Services Inc.

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

$1.8M
91417252321$1.3M
101467867143$1.2M
111295988186$1.1M
121871704544$1.1M
131841409307$1.1M
141205037900$1.1M
151922160571$1.1M
161225239387$1.1M
171336340157$1.0M
181295944759$1.0M
191558766329$984K
201396954855$976K

Showing top 20 of 41 providers billing this code