T1023
Screening to determine appropriateness of consideration for program
Screening to determine appropriateness of consideration for program is the #291 most-billed Medicaid procedure code, with $486.5M in payments across 2.2M claims from 2018–2024. The national median cost per claim is $106.70. Costs vary widely — the 90th percentile is $345.10 per claim, 3.2× the median.
Total Paid
$486.5M
0.04% of all spending
Total Claims
2.2M
Providers
1K
Avg Cost/Claim
$226
National Cost Distribution
How much do providers bill per claim for T1023? Based on 1K providers billing this code nationally.
Median
$106.70
Average
$160.49
Std Dev
$179.93
Max
$2,544.80
Percentile Distribution (Cost per Claim)
50% of providers bill between $49.22 and $227.92 per claim for this code.
90% bill between $26.65 and $345.10.
Top 1% bill above $852.43.
About This Procedure
HCPCS code T1023 (Screening to determine appropriateness of consideration for program) was billed by 1K providers across 2.2M claims, totaling $486.5M in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$106.70
Providers Billing
1K
National Spending
$486.5M
Avg/Median Ratio
1.50×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for T1023
| # | Provider | Total Paid |
|---|---|---|
| 1 | Baltimore County Public Schools Towson, MD · Local Education Agency (LEA) | $20.3M |
| 2 | Baltimore City Schools Baltimore, MD · Local Education Agency (LEA) | $17.6M |
| 3 | Community Mental Health Authority Of Clinton Eaton Ingham Counties Lansing, MI · Clinic/Center Mental Health (Including Community Mental Health Center) | $16.4M |
| 4 | 1225100944 | $16.2M |
| 5 | 1477694925 | $16.1M |
| 6 | 1134212442 | $13.1M |
| 7 | Community Mental Health For Central Michigan Mt Pleasant, MI · Psychiatry & Neurology Psychiatry | $12.8M |
| 8 | Prince Georges County Public Schools Upper Marlboro, MD · Local Education Agency (LEA) | $11.5M |
| 9 | 1548657554 | $11.2M |
| 10 | 1578890273 | $10.0M |
| 11 | 1184684979 | $9.9M |
| 12 | 1760535504 | $9.9M |
| 13 | 1477765139 | $7.7M |
| 14 | 1528222957 | $7.1M |
| 15 | 1851536502 | $7.0M |
| 16 | Saginaw County Community Mental Health Authority Saginaw, MI · Community/Behavioral Health | $7.0M |
| 17 | Northern Lakes Community Mental Health Authority Traverse City, MI · Occupational Therapist | $6.9M |
| 18 | 1104341080 | $6.8M |
| 19 | 1538437009 | $6.4M |
| 20 | 1467805861 | $6.2M |
Showing top 20 of 1K providers billing this code