T1019
Personal care services, per 15 min
Personal care services, per 15 min is the #1 most-billed Medicaid procedure code, with $122.74B in payments across 1.1B claims from 2018–2024. The national median cost per claim is $82.47. Costs vary widely — the 90th percentile is $317.20 per claim, 3.8× the median.
Total Paid
$122.74B
11.22% of all spending
Total Claims
1.1B
Providers
10K
Avg Cost/Claim
$112
National Cost Distribution
How much do providers bill per claim for T1019? Based on 10K providers billing this code nationally.
Median
$82.47
Average
$151.21
Std Dev
$233.39
Max
$5,513.49
Percentile Distribution (Cost per Claim)
50% of providers bill between $57.29 and $149.67 per claim for this code.
90% bill between $30.08 and $317.20.
Top 1% bill above $1,171.01.
About This Procedure
HCPCS code T1019 (Personal care services, per 15 min) was billed by 10K providers across 1.1B claims, totaling $122.74B in Medicaid payments from 2018–2024. This code was used for 55.7M unique beneficiaries.
Investigation Context
Personal care services (T1019) is the #1 spending code in all of Medicaid. Services are provided in private homes, making them difficult to verify. The HHS OIG identifies personal care as the highest fraud-risk Medicaid category.
Fraud Risk Context
The OIG identifies personal care services as the #1 fraud-risk category in Medicaid. Home care agencies have been the subject of numerous federal investigations.
Source: HHS OIG Work Plan
Risk Assessment
This procedure is featured in our investigation: Arizona Problem
Read the full analysis for context on billing patterns associated with this code.
Billing Statistics
Median Cost/Claim
$82.47
Providers Billing
10K
National Spending
$122.74B
Avg/Median Ratio
1.83×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for T1019
| # | Provider | Total Paid |
|---|---|---|
| 1 | Tempus Unlimited, Inc. Stoughton, MA · Voluntary or Charitable | $5.46B |
| 2 | Freedom Care Llc New Hyde Park, NY · Home Health | $3.00B |
| 3 | Public Partnerships Llc Latham, NY · Supports Brokerage | $2.70B |
| 4 | American Business Institute Corp Flushing, NY · Home Health | $1.62B |
| 5 | Premier Home Health Care Services Inc New York, NY · Home Health | $1.30B |
| 6 | Assistcarehome Healthcare Services Brooklyn, NY · Home Health | $1.27B |
| 7 | Heart To Heart Home Care Inc. Brooklyn, NY · Home Health | $1.08B |
| 8 | Marks Homecare Agency Inc Corona, NY · In Home Supportive Care | $1.07B |
| 9 | Stavros Center For Independent Living Inc. Amherst, MA · Case Management | $1.03B |
| 10 | Nae Edison Llc Brooklyn, NY · Home Health | $990.8M |
| 11 | Health Acquisition Corp. Forest Hills, NY · Home Health | $977.0M |
| 12 | New Partners Inc New York, NY · Home Health | $952.5M |
| 13 | Concepts Of Independence Inc. New York, NY · Home Health | $945.8M |
| 14 | Caring Professionals Inc Forest Hills, NY · Home Health | $904.4M |
| 15 | C And T Homecare Services Llc Great Neck, NY · In Home Supportive Care | $831.2M |
| 16 | Guardiantrac. Llc Sturgis, MI · Community/Behavioral Health | $825.6M |
| 17 | Home Family Care Inc Brooklyn, NY · Home Health | $775.7M |
| 18 | Human Care Llc Brooklyn, NY · Home Health | $764.6M |
| 19 | Platinum Home Health Care Inc. Brooklyn, NY · Home Health | $763.7M |
| 20 | A & J Staffing Inc Brooklyn, NY · Home Health | $753.2M |
Showing top 20 of 10K providers billing this code