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#454 of 11K

S9131

Physical therapy, in the home, per diem

Physical therapy, in the home, per diem is the #454 most-billed Medicaid procedure code, with $215.4M in payments across 2.4M claims from 2018–2024. The national median cost per claim is $90.35.

Total Paid

$215.4M

0.02% of all spending

Total Claims

2.4M

Providers

522

Avg Cost/Claim

$89

National Cost Distribution

How much do providers bill per claim for S9131? Based on 492 providers billing this code nationally.

Median

$90.35

Average

$89.69

Std Dev

$54.66

Max

$568.86

Percentile Distribution (Cost per Claim)

p10
$26.50
p25
$63.63
Median
$90.35
p75
$109.21
p90
$134.21
p95
$158.66
p99
$276.03

50% of providers bill between $63.63 and $109.21 per claim for this code.

90% bill between $26.50 and $134.21.

Top 1% bill above $276.03.

About This Procedure

HCPCS code S9131 (Physical therapy, in the home, per diem) was billed by 522 providers across 2.4M claims, totaling $215.4M in Medicaid payments from 2018–2024. This code was used for 676K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$90.35

Providers Billing

492

National Spending

$215.4M

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for S9131

#ProviderTotal Paid
11962728071$11.5M
21528059805$8.6M
31932227790$8.3M
4Extended Nursing Personnel Chha, Llc

Brooklyn, NY · Home Health

$7.7M
51467412296$5.2M
61730268384$5.2M
71396926994$4.8M
81265591168$3.6M
9Americare Certified Special Services Inc.

Brooklyn, NY · Home Health

$3.4M
101801819271$3.1M
111780670711$2.4M
121730171547$2.2M
13Easter Seals Delaware & Marylands Eastern Shore Inc

New Castle, DE · Psychologist Intellectual & Developmental Disabilities

$2.2M
141750897609$2.2M
151861464471$2.2M
161447344098$2.2M
171720019144$2.2M
181558493270$2.2M
191962479667$2.1M
201003872862$2.1M

Showing top 20 of 522 providers billing this code