W0725
Waiver service, state-specific code
Waiver service, state-specific code is the #410 most-billed Medicaid procedure code, with $255.1M in payments across 100K claims from 2018–2024. The national median cost per claim is $5,225.66.
Total Paid
$255.1M
0.02% of all spending
Total Claims
100K
Providers
26
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for W0725? Based on 26 providers billing this code nationally.
Median
$5,225.66
Average
$4,955.45
Std Dev
$1,516.91
Max
$8,508.76
Percentile Distribution (Cost per Claim)
50% of providers bill between $4,147.50 and $5,652.92 per claim for this code.
90% bill between $3,400.21 and $6,415.88.
Top 1% bill above $8,026.47.
About This Procedure
HCPCS code W0725 (Waiver service, state-specific code) was billed by 26 providers across 100K claims, totaling $255.1M in Medicaid payments from 2018–2024. This code was used for 31K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5,225.66
Providers Billing
26
National Spending
$255.1M
Avg/Median Ratio
0.95×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for W0725
| # | Provider | Total Paid |
|---|---|---|
| 1 | Community Living Services Inc Fargo, ND · Community/Behavioral Health | $25.3M |
| 2 | 1407443245 | $23.6M |
| 3 | 1811597867 | $22.6M |
| 4 | 1902404049 | $18.5M |
| 5 | Community Options For Residential And Employment Services, Inc Bismarck, ND · Counselor | $17.3M |
| 6 | 1982202677 | $16.5M |
| 7 | 1356453484 | $16.0M |
| 8 | 1902404957 | $14.6M |
| 9 | Open Door Center Valley City, ND · Community/Behavioral Health | $13.4M |
| 10 | 1619013430 | $13.3M |
| 11 | 1558961391 | $13.0M |
| 12 | 1679171235 | $11.4M |
| 13 | 1639507304 | $7.2M |
| 14 | 1700487915 | $5.6M |
| 15 | 1972101343 | $5.4M |
| 16 | 1013285337 | $5.4M |
| 17 | 1629677463 | $4.1M |
| 18 | 1912506809 | $3.8M |
| 19 | 1215442231 | $3.8M |
| 20 | 1225638992 | $3.3M |
Showing top 20 of 26 providers billing this code