M0420
HCPCS Procedure Code
HCPCS code M0420 is the #3,464 most-billed Medicaid procedure code, with $1.6M in payments across 29K claims from 2018–2024. The national median cost per claim is $49.34. Costs vary widely — the 90th percentile is $106.81 per claim, 2.2× the median.
Total Paid
$1.6M
0.00% of all spending
Total Claims
29K
Providers
7
Avg Cost/Claim
$57
National Cost Distribution
How much do providers bill per claim for M0420? Based on 7 providers billing this code nationally.
Median
$49.34
Average
$62.78
Std Dev
$45.89
Max
$161.20
Percentile Distribution (Cost per Claim)
50% of providers bill between $37.44 and $64.34 per claim for this code.
90% bill between $32.09 and $106.81.
Top 1% bill above $155.77.
About This Procedure
HCPCS code M0420 was billed by 7 providers across 29K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$49.34
Providers Billing
7
National Spending
$1.6M
Avg/Median Ratio
1.27×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for M0420
| # | Provider | Total Paid |
|---|---|---|
| 1 | Consumer Directed Services In Texas Inc. San Antonio, TX · Supports Brokerage | $567K |
| 2 | Segnik Group Inc Houston, TX · Supports Brokerage | $389K |
| 3 | Alamo Consumer Direct, Llc Austin, TX · Supports Brokerage | $343K |
| 4 | Acumen Fiscal Agent Llc Mesa, AZ · Community/Behavioral Health | $270K |
| 5 | Eak Good Neighbor Properties Mount Vernon, TX · Day Training, Developmentally Disabled Services | $43K |
| 6 | 1124158175 | $18K |
| 7 | Imagine Enterprises Seabrook, TX · Supports Brokerage | $14K |
Showing top 7 of 7 providers billing this code