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#2 of 11K

T1015

Clinic visit/encounter, all-inclusive

Clinic visit/encounter, all-inclusive is the #2 most-billed Medicaid procedure code, with $49.15B in payments across 322.2M claims from 2018–2024. The national median cost per claim is $121.16.

Total Paid

$49.15B

4.49% of all spending

Total Claims

322.2M

Providers

14K

Avg Cost/Claim

$153

National Cost Distribution

How much do providers bill per claim for T1015? Based on 13K providers billing this code nationally.

Median

$121.16

Average

$135.42

Std Dev

$124.83

Max

$7,079.77

Percentile Distribution (Cost per Claim)

p10
$32.69
p25
$65.06
Median
$121.16
p75
$174.51
p90
$235.99
p95
$293.31
p99
$567.43

50% of providers bill between $65.06 and $174.51 per claim for this code.

90% bill between $32.69 and $235.99.

Top 1% bill above $567.43.

About This Procedure

HCPCS code T1015 (Clinic visit/encounter, all-inclusive) was billed by 14K providers across 322.2M claims, totaling $49.15B in Medicaid payments from 2018–2024. This code was used for 235.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$121.16

Providers Billing

13K

National Spending

$49.15B

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T1015

#ProviderTotal Paid
1Community Health Center Inc

Middletown, CT · Counselor, Addiction (Substance Use Disorder)

$511.8M
2El Rio Santa Cruz Neighborhood Health Center, Inc

Tucson, AZ · Clinic/Center, Federally Qualified Health Center (FQHC)

$357.8M
3Mountain Park Health Center

Phoenix, AZ · Clinic/Center, Federally Qualified Health Center (FQHC)

$345.4M
4Legacy Community Health Services, Inc

Houston, TX · Pediatrics

$336.7M
5Stillaguamish Tribe Of Indians

Arlington, WA · Clinic/Center Rehabilitation Substance Use Disorder

$333.8M
6Altamed Health Services Corp.

Los Angeles, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$298.9M
7Cornell Scott Hill Health Corporation

New Haven, CT · Psychiatry & Neurology, Child & Adolescent Psychiatry

$269.7M
8We Care Daily Clinics Llc

Auburn, WA · Clinic/Center Methadone Clinic

$248.2M
9Adelante Healthcare, Inc.

Phoenix, AZ · Family Medicine

$244.8M
10Sac Health System

San Bernardino, CA · Clinic/Center, Community Health

$227.8M
11Family Healthcare Network

Fresno, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$196.5M
12Swinomish Health Services

Anacortes, WA · Clinic/Center Rehabilitation Substance Use Disorder

$186.6M
13County Of Santa Clara

San Jose, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$173.5M
14County Of Los Angeles

Los Angeles, CA · General Acute Care Hospital

$167.9M
15Contra Costa County

Pittsburg, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$160.8M
16Neighborhood Healthcare

Hemet, CA · Clinic/Center, Federally Qualified Health Center (FQHC)

$146.8M
17Erie Family Health Center, Inc

Chicago, IL · Clinic/Center, Federally Qualified Health Center (FQHC)

$138.0M
18Contra Costa County

San Pablo, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$135.8M
19La Maestra Family Clinic, Inc.

San Diego, CA · Clinic/Center, Federally Qualified Health Center (FQHC)

$134.4M
20County Of Santa Clara

San Jose, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$123.1M

Showing top 20 of 14K providers billing this code