W1793
State-defined waiver service
State-defined waiver service is the #85 most-billed Medicaid procedure code, with $2.26B in payments across 13.1M claims from 2018–2024. The national median cost per claim is $170.32.
Total Paid
$2.26B
0.21% of all spending
Total Claims
13.1M
Providers
380
Avg Cost/Claim
$172
National Cost Distribution
How much do providers bill per claim for W1793? Based on 380 providers billing this code nationally.
Median
$170.32
Average
$169.95
Std Dev
$31.05
Max
$290.22
Percentile Distribution (Cost per Claim)
50% of providers bill between $149.15 and $186.85 per claim for this code.
90% bill between $132.73 and $210.17.
Top 1% bill above $255.96.
About This Procedure
HCPCS code W1793 (State-defined waiver service) was billed by 380 providers across 13.1M claims, totaling $2.26B in Medicaid payments from 2018–2024. This code was used for 527K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$170.32
Providers Billing
380
National Spending
$2.26B
Avg/Median Ratio
1.00×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for W1793
| # | Provider | Total Paid |
|---|---|---|
| 1 | Excel Copmanion Care Inc Warminster, PA · Home Health | $307.6M |
| 2 | Patriot Home Care Inc Philadelphia, PA · Home Health | $135.8M |
| 3 | Intra-national Home Care, Llc Columbus, OH · In Home Supportive Care | $57.3M |
| 4 | 1477830305 | $55.7M |
| 5 | Ameribest Home Care Llc Philadelphia, PA · Home Health | $55.3M |
| 6 | 1932504982 | $46.1M |
| 7 | 1417368697 | $44.9M |
| 8 | 1497846992 | $44.3M |
| 9 | 1063426831 | $43.0M |
| 10 | 1356892699 | $42.0M |
| 11 | 1508926981 | $31.9M |
| 12 | 1609150846 | $31.4M |
| 13 | 1689183857 | $31.1M |
| 14 | 1851835490 | $25.7M |
| 15 | 1922424845 | $25.3M |
| 16 | 1295237626 | $25.1M |
| 17 | 1306025135 | $23.3M |
| 18 | 1114168952 | $21.1M |
| 19 | 1043531361 | $20.9M |
| 20 | 1407375611 | $20.2M |
Showing top 20 of 380 providers billing this code