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#414 of 11K

T2015

Habilitation, prevocational, waiver, per diem

Habilitation, prevocational, waiver, per diem is the #414 most-billed Medicaid procedure code, with $252.1M in payments across 1.9M claims from 2018–2024. The national median cost per claim is $88.27. Costs vary widely — the 90th percentile is $843.67 per claim, 9.6× the median.

Total Paid

$252.1M

0.02% of all spending

Total Claims

1.9M

Providers

348

Avg Cost/Claim

$130

National Cost Distribution

How much do providers bill per claim for T2015? Based on 316 providers billing this code nationally.

Median

$88.27

Average

$298.97

Std Dev

$587.36

Max

$6,296.77

Percentile Distribution (Cost per Claim)

p10
$34.58
p25
$50.28
Median
$88.27
p75
$319.70
p90
$843.67
p95
$1,116.16
p99
$2,003.18

50% of providers bill between $50.28 and $319.70 per claim for this code.

90% bill between $34.58 and $843.67.

Top 1% bill above $2,003.18.

About This Procedure

HCPCS code T2015 (Habilitation, prevocational, waiver, per diem) was billed by 348 providers across 1.9M claims, totaling $252.1M in Medicaid payments from 2018–2024. This code was used for 301K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$88.27

Providers Billing

316

National Spending

$252.1M

Avg/Median Ratio

3.39×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for T2015

#ProviderTotal Paid
1Community Assistance Resources & Extended Services Inc

New York, NY · Case Management

$47.5M
2Disability Services Of The Southwest, Inc

San Antonio, TX · Day Training, Developmentally Disabled Services

$9.1M
3Caregivers Home Health Tx Inc

Richardson, TX · Nursing Care

$9.0M
4Alabama Department Of Mental Health And Mental Retardation

Montgomery, AL · Community/Behavioral Health

$6.1M
5Living Innovations Support Services Llc

Dover, NH · Day Training Developmentally Disabled Services

$5.8M
61740656628$5.7M
7Human Care Services For Families And Children Inc

Brooklyn, NY · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities

$4.9M
8Astrocare Class, Inc.

Houston, TX · Home Health

$4.8M
91982610572$4.8M
101972959179$4.5M
11Hamaspik Of Kings County Inc.

Brooklyn, NY · Case Management

$3.8M
121295179489$3.5M
131326454687$3.3M
141538563747$3.2M
151407220601$3.1M
161558484394$3.0M
171306178694$2.9M
181083953095$2.7M
191164931952$2.7M
20Perspectives Corporation

North Kingstown, RI · Day Training Developmentally Disabled Services

$2.5M

Showing top 20 of 348 providers billing this code