| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1016 |
Case management, each 15 minutes |
923,562 |
451,342 |
$37.25M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
105,097 |
94,336 |
$7.57M |
| H0031 |
Mental health assessment, by non-physician |
48,750 |
44,113 |
$7.54M |
| T1003 |
Lpn/lvn services, up to 15 minutes |
495,143 |
42,502 |
$6.74M |
| H2010 |
Comprehensive medication services, per 15 minutes |
606,514 |
40,457 |
$6.46M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
87,227 |
41,203 |
$5.32M |
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
24,670 |
1,528 |
$4.91M |
| H0038 |
Self-help/peer services, per 15 minutes |
167,559 |
43,279 |
$4.71M |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
67,971 |
61,905 |
$3.90M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32,716 |
30,123 |
$1.75M |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
443,862 |
39,527 |
$1.33M |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
7,583 |
7,280 |
$1.16M |
| 82075 |
|
33,734 |
12,720 |
$946K |
| T1002 |
Rn services, up to 15 minutes |
51,818 |
23,196 |
$930K |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
82,400 |
53,749 |
$927K |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
6,724 |
1,500 |
$883K |
| 90834 |
Psychotherapy, 45 minutes with patient |
9,924 |
6,430 |
$812K |
| 90837 |
Psychotherapy, 53 minutes with patient |
4,014 |
2,573 |
$523K |
| 90791 |
Psychiatric diagnostic evaluation |
3,557 |
3,335 |
$472K |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
6,478 |
4,498 |
$348K |
| S0215 |
Non-emergency transportation; mileage, per mile |
20,307 |
4,754 |
$285K |
| 80305 |
|
34,649 |
25,725 |
$259K |
| H0034 |
Medication training and support, per 15 minutes |
23,607 |
8,855 |
$259K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
19,832 |
4,566 |
$246K |
| H2027 |
Psychoeducational service, per 15 minutes |
7,358 |
4,543 |
$230K |
| 99443 |
|
2,345 |
2,220 |
$191K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,371 |
1,295 |
$169K |
| H2014 |
Skills training and development, per 15 minutes |
15,086 |
4,786 |
$148K |
| H2016 |
Comprehensive community support services, per diem |
436 |
409 |
$133K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,070 |
1,178 |
$127K |
| 99441 |
|
3,373 |
3,053 |
$120K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
4,514 |
2,061 |
$117K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
9,624 |
7,888 |
$113K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
5,015 |
4,893 |
$100K |
| 99442 |
|
1,653 |
1,533 |
$99K |
| H0033 |
Oral medication administration, direct observation |
5,976 |
713 |
$94K |
| 93000 |
|
6,072 |
5,206 |
$86K |
| S5110 |
Home care training, family; per 15 minutes |
2,292 |
1,520 |
$65K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,691 |
1,447 |
$58K |
| 81025 |
|
8,324 |
6,751 |
$58K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
674 |
643 |
$57K |
| 90832 |
Psychotherapy, 30 minutes with patient |
833 |
703 |
$49K |
| G2067 |
Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) |
3,716 |
900 |
$48K |
| 99215 |
Prolong outpt/office vis |
319 |
307 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,022 |
925 |
$29K |
| 99385 |
|
184 |
183 |
$25K |
| 36415 |
Collection of venous blood by venipuncture |
2,277 |
2,088 |
$10K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,742 |
1,496 |
$10K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
68 |
67 |
$9K |
| H2025 |
Ongoing support to maintain employment, per 15 minutes |
610 |
540 |
$7K |
| 90686 |
|
336 |
310 |
$7K |
| 99386 |
|
37 |
37 |
$5K |
| 99205 |
Prolong outpt/office vis |
28 |
25 |
$4K |
| 90836 |
|
51 |
49 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
55 |
53 |
$3K |
| G2077 |
Periodic assessment; assessing periodically by an otp practitioner and includes a review of moud dosing, treatment response, other substance use disorder treatment needs, responses and patient-identified goals, and other relevant physical, nutrition and psychiatric treatment needs and goals; may be informed by administration of a standardized, evidence-based assessment, or the need and interest for harm reduction interventions and recovery support services (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to each primary code |
414 |
275 |
$3K |
| 86580 |
|
294 |
273 |
$3K |
| 69210 |
|
43 |
41 |
$2K |
| 90715 |
|
28 |
28 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 90658 |
|
98 |
82 |
$1K |
| J1631 |
Injection, haloperidol decanoate, per 50 mg |
175 |
129 |
$1K |
| 83037 |
|
78 |
74 |
$795.52 |
| 90632 |
|
14 |
14 |
$569.50 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
1,023 |
699 |
$401.86 |
| A0160 |
Non-emergency transportation: per mile - case worker or social worker |
394 |
343 |
$258.30 |
| 82962 |
|
31 |
27 |
$76.59 |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
1,854 |
1,687 |
$14.50 |
| G0404 |
Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination |
15 |
12 |
$0.00 |
| 1159F |
|
14 |
13 |
$0.00 |
| 3079F |
|
13 |
13 |
$0.00 |
| 3074F |
|
27 |
26 |
$0.00 |