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#4366 of 11K

M0248

HCPCS Procedure Code

HCPCS code M0248 is the #4,366 most-billed Medicaid procedure code, with $632K in payments across 76K claims from 2018–2024. The national median cost per claim is $5.31. Costs vary widely — the 90th percentile is $15.83 per claim, 3.0× the median.

Total Paid

$632K

0.00% of all spending

Total Claims

76K

Providers

95

Avg Cost/Claim

$8

National Cost Distribution

How much do providers bill per claim for M0248? Based on 94 providers billing this code nationally.

Median

$5.31

Average

$34.45

Std Dev

$129.55

Max

$774.27

Percentile Distribution (Cost per Claim)

p10
$2.47
p25
$4.00
Median
$5.31
p75
$9.20
p90
$15.83
p95
$137.18
p99
$760.22

50% of providers bill between $4.00 and $9.20 per claim for this code.

90% bill between $2.47 and $15.83.

Top 1% bill above $760.22.

About This Procedure

HCPCS code M0248 was billed by 95 providers across 76K claims, totaling $632K in Medicaid payments from 2018–2024. This code was used for 66K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.31

Providers Billing

94

National Spending

$632K

Avg/Median Ratio

6.49×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for M0248

#ProviderTotal Paid
11588298053$172K
2Berry Family Services

Rowlett, TX · Case Management

$45K
3Daybreak Community Services Texas Llc

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

$42K
41932342276$27K
5D&s Residential Services, Lp

Austin, TX · Intermediate Care Facility, Intellectual Disabilities

$26K
61811039225$14K
7Lifetime Living Inc.

San Antonio, TX · Case Management

$13K
8St. Giles Living Centers, Inc.

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

$13K
91003978230$12K
101871794933$11K
111598084774$10K
12Abiding Choice Inc

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

$9K
13Wellness Healthcare Solutions Inc.

Desoto, TX · Day Training, Developmentally Disabled Services

$8K
14Kenmar Residential Hcs Services Inc.

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

$8K
151427259241$8K
161841409307$8K
171871704544$8K
181518062520$8K
191790860666$7K
201700926987$7K

Showing top 20 of 95 providers billing this code