M0355
HCPCS Procedure Code
HCPCS code M0355 is the #837 most-billed Medicaid procedure code, with $69.0M in payments across 255K claims from 2018–2024. The national median cost per claim is $196.65. Costs vary widely — the 90th percentile is $556.20 per claim, 2.8× the median.
Total Paid
$69.0M
0.01% of all spending
Total Claims
255K
Providers
11
Avg Cost/Claim
$271
National Cost Distribution
How much do providers bill per claim for M0355? Based on 11 providers billing this code nationally.
Median
$196.65
Average
$342.44
Std Dev
$399.45
Max
$1,496.48
Percentile Distribution (Cost per Claim)
50% of providers bill between $168.04 and $243.82 per claim for this code.
90% bill between $160.09 and $556.20.
Top 1% bill above $1,402.45.
About This Procedure
HCPCS code M0355 was billed by 11 providers across 255K claims, totaling $69.0M in Medicaid payments from 2018–2024. This code was used for 17K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$196.65
Providers Billing
11
National Spending
$69.0M
Avg/Median Ratio
1.74×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for M0355
| # | Provider | Total Paid |
|---|---|---|
| 1 | Consumer Directed Services In Texas Inc. San Antonio, TX · Supports Brokerage | $25.6M |
| 2 | Alamo Consumer Direct, Llc Austin, TX · Supports Brokerage | $7.5M |
| 3 | Segnik Group Inc Houston, TX · Supports Brokerage | $7.3M |
| 4 | Acumen Fiscal Agent Llc Mesa, AZ · Community/Behavioral Health | $7.2M |
| 5 | 1124158175 | $5.3M |
| 6 | Eak Good Neighbor Properties Mount Vernon, TX · Day Training, Developmentally Disabled Services | $4.5M |
| 7 | In-home Attendant Services Ltd. Houston, TX · Technician Personal Care Attendant | $4.1M |
| 8 | 1578631024 | $2.9M |
| 9 | 1720149982 | $2.6M |
| 10 | 1497049779 | $1.7M |
| 11 | 1932486925 | $474K |
Showing top 11 of 11 providers billing this code