T1025
Waiver services, NOS, per 15 minutes
Waiver services, NOS, per 15 minutes is the #172 most-billed Medicaid procedure code, with $996.7M in payments across 4.4M claims from 2018–2024. The national median cost per claim is $227.80. Costs vary widely — the 90th percentile is $555.10 per claim, 2.4× the median.
Total Paid
$996.7M
0.09% of all spending
Total Claims
4.4M
Providers
252
Avg Cost/Claim
$228
National Cost Distribution
How much do providers bill per claim for T1025? Based on 240 providers billing this code nationally.
Median
$227.80
Average
$310.27
Std Dev
$356.17
Max
$4,740.65
Percentile Distribution (Cost per Claim)
50% of providers bill between $191.64 and $284.07 per claim for this code.
90% bill between $158.04 and $555.10.
Top 1% bill above $1,143.10.
About This Procedure
HCPCS code T1025 (Waiver services, NOS, per 15 minutes) was billed by 252 providers across 4.4M claims, totaling $996.7M in Medicaid payments from 2018–2024. This code was used for 329K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$227.80
Providers Billing
240
National Spending
$996.7M
Avg/Median Ratio
1.36×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for T1025
| # | Provider | Total Paid |
|---|---|---|
| 1 | Kyppec,inc Louisville, KY · Skilled Nursing Facility, Nursing Care, Pediatric | $75.3M |
| 2 | 1760515977 | $35.8M |
| 3 | 1366810079 | $15.8M |
| 4 | 1518368471 | $14.6M |
| 5 | 1255431284 | $13.5M |
| 6 | 1073550877 | $12.9M |
| 7 | 1487003539 | $12.4M |
| 8 | 1164962056 | $12.3M |
| 9 | 1508016387 | $12.1M |
| 10 | 1689758328 | $11.5M |
| 11 | Pediatrust Lake Charles Llc Lake Charles, LA · Exclusive Provider Organization | $11.2M |
| 12 | 1639606940 | $11.1M |
| 13 | 1598029092 | $11.1M |
| 14 | 1093198731 | $10.2M |
| 15 | 1134660731 | $9.6M |
| 16 | 1568896561 | $9.4M |
| 17 | 1588915268 | $9.4M |
| 18 | 1447342357 | $9.3M |
| 19 | 1740440056 | $9.3M |
| 20 | 1700230117 | $9.2M |
Showing top 20 of 252 providers billing this code