T2042
Financial management, self-directed, waiver, per month
Financial management, self-directed, waiver, per month is the #394 most-billed Medicaid procedure code, with $275.4M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $188.03. Costs vary widely — the 90th percentile is $3,587.43 per claim, 19.1× the median.
Total Paid
$275.4M
0.03% of all spending
Total Claims
1.3M
Providers
168
Avg Cost/Claim
$209
National Cost Distribution
How much do providers bill per claim for T2042? Based on 168 providers billing this code nationally.
Median
$188.03
Average
$1,084.57
Std Dev
$1,414.38
Max
$4,829.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $144.16 and $2,208.04 per claim for this code.
90% bill between $122.16 and $3,587.43.
Top 1% bill above $4,399.32.
About This Procedure
HCPCS code T2042 (Financial management, self-directed, waiver, per month) was billed by 168 providers across 1.3M claims, totaling $275.4M in Medicaid payments from 2018–2024. This code was used for 77K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$188.03
Providers Billing
168
National Spending
$275.4M
Avg/Median Ratio
5.77×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for T2042
| # | Provider | Total Paid |
|---|---|---|
| 1 | Tridia Hospice Care, Llc Westerville, OH · Hospice Care, Community Based | $15.9M |
| 2 | 1255333753 | $12.4M |
| 3 | 1215981329 | $11.1M |
| 4 | 1538451034 | $10.9M |
| 5 | 1174520076 | $9.5M |
| 6 | 1598740011 | $8.7M |
| 7 | 1538185830 | $6.7M |
| 8 | 1568505105 | $6.6M |
| 9 | 1437432929 | $6.5M |
| 10 | 1447344130 | $6.3M |
| 11 | 1720153711 | $6.3M |
| 12 | 1194251371 | $5.7M |
| 13 | 1346220142 | $5.4M |
| 14 | 1699840736 | $5.2M |
| 15 | 1598738718 | $4.9M |
| 16 | 1669548053 | $4.8M |
| 17 | 1588682405 | $4.8M |
| 18 | 1205876653 | $4.7M |
| 19 | 1508969072 | $4.7M |
| 20 | 1861503534 | $4.5M |
Showing top 20 of 168 providers billing this code