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#42 of 11K

T2031

Waiver services, not otherwise specified

Waiver services, not otherwise specified is the #42 most-billed Medicaid procedure code, with $4.65B in payments across 14.3M claims from 2018–2024. The national median cost per claim is $853.15. Costs vary widely — the 90th percentile is $2,456.84 per claim, 2.9× the median.

Total Paid

$4.65B

0.43% of all spending

Total Claims

14.3M

Providers

2K

Avg Cost/Claim

$326

National Cost Distribution

How much do providers bill per claim for T2031? Based on 2K providers billing this code nationally.

Median

$853.15

Average

$1,092.21

Std Dev

$978.07

Max

$8,436.35

Percentile Distribution (Cost per Claim)

p10
$107.63
p25
$234.94
Median
$853.15
p75
$1,648.27
p90
$2,456.84
p95
$3,074.69
p99
$3,857.00

50% of providers bill between $234.94 and $1,648.27 per claim for this code.

90% bill between $107.63 and $2,456.84.

Top 1% bill above $3,857.00.

About This Procedure

HCPCS code T2031 (Waiver services, not otherwise specified) was billed by 2K providers across 14.3M claims, totaling $4.65B in Medicaid payments from 2018–2024. This code was used for 1.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$853.15

Providers Billing

2K

National Spending

$4.65B

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T2031

#ProviderTotal Paid
11134773047$40.4M
21649669193$39.1M
31093254435$31.8M
41881767069$30.3M
51932370343$29.6M
61578075750$26.2M
71790819423$26.1M
81295139632$24.9M
91952738445$23.3M
101114101102$22.0M
111215211305$21.6M
121407266836$21.4M
131851803431$21.1M
141134487556$21.0M
151154592467$20.6M
161003952037$20.4M
171306433644$20.2M
181265945885$20.1M
191134268030$19.0M
201326436270$18.9M

Showing top 20 of 2K providers billing this code