#47 of 11K

T2046

Habilitation, residential, waiver; per month

Habilitation, residential, waiver; per month is the #47 most-billed Medicaid procedure code, with $4.19B in payments across 14.1M claims from 2018–2024. The national median cost per claim is $1,795.74. Costs vary widely — the 90th percentile is $3,726.31 per claim, 2.1× the median.

Total Paid

$4.19B

0.38% of all spending

Total Claims

14.1M

Providers

831

Avg Cost/Claim

$298

National Cost Distribution

How much do providers bill per claim for T2046? Based on 823 providers billing this code nationally.

Median

$1,795.74

Average

$1,679.67

Std Dev

$1,466.09

Max

$8,789.47

Percentile Distribution (Cost per Claim)

p10

$132.63

p25

$185.20

Median

$1,795.74

p75

$2,759.56

p90

$3,726.31

p95

$4,039.75

p99

$5,058.77

50% of providers bill between $185.20 and $2,759.56 per claim for this code.

90% bill between $132.63 and $3,726.31.

Top 1% bill above $5,058.77.

About This Procedure

HCPCS code T2046 (Habilitation, residential, waiver; per month) was billed by 831 providers across 14.1M claims, totaling $4.19B in Medicaid payments from 2018–2024. This code was used for 1.0M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,795.74

Providers Billing

823

National Spending

$4.19B

Avg/Median Ratio

0.94×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for T2046

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Tridia Hospice Care, Llc Westerville, OH · Hospice Care, Community Based	$122.9M	$177.26	0.1× median	Below Median
2	1538451034	$106.1M	$3,824.08	2.1× median	Top 10%
3	1932283694	$72.4M	$4,345.96	2.4× median	Top 10%
4	1346220142	$63.0M	$135.81	0.1× median	Below Median
5	1447344130	$59.6M	$4,182.68	2.3× median	Top 10%
6	1255333753	$56.0M	$170.32	0.1× median	Below Median
7	1437432929	$54.8M	$137.48	0.1× median	Below Median
8	1558445569	$47.0M	$527.48	0.3× median	Below Median
9	Tidewell Hospice Inc. Sarasota, FL · Hospice Care Community Based	$45.8M	$171.40	0.1× median	Below Median
10	1205876653	$42.8M	$192.88	0.1× median	Below Median
11	1598740011	$42.3M	$140.18	0.1× median	Below Median
12	1780937649	$40.5M	$3,718.64	2.1× median	Above 75th
13	1427380625	$40.4M	$749.81	0.4× median	Below Median
14	1578864377	$38.4M	$189.44	0.1× median	Below Median
15	1104864198	$38.1M	$144.07	0.1× median	Below Median
16	1669548053	$37.8M	$3,303.65	1.8× median	Above 75th
17	1568505105	$37.6M	$137.81	0.1× median	Below Median
18	1467635706	$36.3M	$3,437.89	1.9× median	Above 75th
19	1538185830	$35.8M	$548.25	0.3× median	Below Median
20	1467507657	$35.2M	$2,107.43	1.2× median	Above Median

Showing top 20 of 831 providers billing this code

Related Procedures

T2048Behavioral health; long-term residential, per diem$958.7M T2040Financial management, self-directed; per month$570.2M T2042Financial management, self-directed, waiver, per month$275.4M T2041Supports brokerage, self-directed; per 15 min$216.6M T2039$30.5M

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