#100 of 11K

T2013

Habilitation, residential, waiver, per hour

Habilitation, residential, waiver, per hour is the #100 most-billed Medicaid procedure code, with $1.97B in payments across 12.2M claims from 2018–2024. The national median cost per claim is $158.23. Costs vary widely — the 90th percentile is $443.43 per claim, 2.8× the median.

Total Paid

$1.97B

0.18% of all spending

Total Claims

12.2M

Providers

254

Avg Cost/Claim

$161

National Cost Distribution

How much do providers bill per claim for T2013? Based on 248 providers billing this code nationally.

Median

$158.23

Average

$457.85

Std Dev

$1,097.91

Max

$7,312.79

Percentile Distribution (Cost per Claim)

p10

$108.54

p25

$137.21

Median

$158.23

p75

$186.49

p90

$443.43

p95

$2,558.88

p99

$5,383.65

50% of providers bill between $137.21 and $186.49 per claim for this code.

90% bill between $108.54 and $443.43.

Top 1% bill above $5,383.65.

About This Procedure

HCPCS code T2013 (Habilitation, residential, waiver, per hour) was billed by 254 providers across 12.2M claims, totaling $1.97B in Medicaid payments from 2018–2024. This code was used for 574K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$158.23

Providers Billing

248

National Spending

$1.97B

Avg/Median Ratio

2.89×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for T2013

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Abound Health, Llc Mint Hill, NC · In Home Supportive Care	$113.9M	$147.48	0.9× median	Below Median
2	Lindley Habilitation Services Inc Greensboro, NC · Community/Behavioral Health	$68.8M	$145.32	0.9× median	Below Median
3	1851539126	$65.5M	$172.54	1.1× median	Above Median
4	Abound Health Llc Mint Hill, NC · Community/Behavioral Health	$64.4M	$146.49	0.9× median	Below Median
5	Universal Mental Health Services Inc. Lenoir, NC · Community/Behavioral Health	$56.4M	$158.23	1.0× median	Above Median
6	Guardiantrac. Llc Sturgis, MI · Community/Behavioral Health	$52.6M	$160.35	1.0× median	Above Median
7	1750431623	$52.3M	$158.52	1.0× median	Above Median
8	1790801819	$50.5M	$144.74	0.9× median	Below Median
9	1821194531	$48.6M	$147.25	0.9× median	Below Median
10	Acumen Fiscal Agent Llc Mesa, AZ · Community/Behavioral Health	$47.6M	$166.19	1.1× median	Above Median
11	1669541538	$38.9M	$187.16	1.2× median	Above 75th
12	1881751865	$37.8M	$121.83	0.8× median	Below Median
13	A Caring Heart Case Management, Inc. Wilson, NC · Case Management	$37.6M	$150.41	1.0× median	Below Median
14	1396811618	$34.3M	$159.30	1.0× median	Above Median
15	1922298942	$32.3M	$152.41	1.0× median	Below Median
16	1922125244	$29.4M	$145.89	0.9× median	Below Median
17	1487695342	$28.5M	$129.08	0.8× median	Below Median
18	1720014855	$24.2M	$158.90	1.0× median	Above Median
19	1619245552	$23.0M	$147.27	0.9× median	Below Median
20	1063798031	$22.3M	$153.20	1.0× median	Below Median

Showing top 20 of 254 providers billing this code

Related Procedures

T2016Habilitation, residential, waiver; per diem$34.90B T2021Day habilitation, waiver; per 15 min$8.65B T2023Community transition, waiver; per service$5.21B T2022Case management, per month$3.75B T2017Habilitation, residential, waiver; 15 min$2.85B

← All procedures Top providers →