W5102
Waiver service, state-specific code
Waiver service, state-specific code is the #471 most-billed Medicaid procedure code, with $202.1M in payments across 3.2M claims from 2018–2024. The national median cost per claim is $62.73.
Total Paid
$202.1M
0.02% of all spending
Total Claims
3.2M
Providers
112
Avg Cost/Claim
$62
National Cost Distribution
How much do providers bill per claim for W5102? Based on 112 providers billing this code nationally.
Median
$62.73
Average
$61.64
Std Dev
$7.45
Max
$73.07
Percentile Distribution (Cost per Claim)
50% of providers bill between $59.00 and $66.84 per claim for this code.
90% bill between $50.19 and $70.24.
Top 1% bill above $72.88.
About This Procedure
HCPCS code W5102 (Waiver service, state-specific code) was billed by 112 providers across 3.2M claims, totaling $202.1M in Medicaid payments from 2018–2024. This code was used for 179K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$62.73
Providers Billing
112
National Spending
$202.1M
Avg/Median Ratio
0.98×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for W5102
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1730337304 | $10.7M |
| 2 | 1497293351 | $8.2M |
| 3 | 1134525470 | $7.6M |
| 4 | 1396164828 | $7.2M |
| 5 | 1578077137 | $6.9M |
| 6 | Arirang Adult Medical Day Care Columbia, MD · Custodial Care Facility | $5.8M |
| 7 | 1013318229 | $5.7M |
| 8 | 1467848564 | $5.4M |
| 9 | 1508304452 | $4.9M |
| 10 | 1407361660 | $4.7M |
| 11 | 1568664407 | $4.6M |
| 12 | Adult Day Health, Inc. Baltimore, MD · Custodial Care Facility | $4.3M |
| 13 | 1699032151 | $4.2M |
| 14 | 1457711160 | $4.0M |
| 15 | 1932582715 | $3.9M |
| 16 | Maryland Medical Day Services Llc Baltimore, MD · Clinic/Center Adult Day Care | $3.5M |
| 17 | 1831315522 | $3.4M |
| 18 | 1568745438 | $3.0M |
| 19 | 1881713295 | $3.0M |
| 20 | 1356889216 | $2.8M |
Showing top 20 of 112 providers billing this code