| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
231,623 |
63,659 |
$23.74M |
| 82075 |
|
117,600 |
38,967 |
$2.03M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,116 |
14,226 |
$1.94M |
| 90837 |
Psychotherapy, 53 minutes with patient |
14,313 |
11,030 |
$1.41M |
| H0048 |
Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
77,241 |
45,365 |
$1.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,330 |
9,611 |
$845K |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
4,013 |
1,479 |
$538K |
| S5001 |
Prescription drug, brand name |
5,504 |
1,414 |
$492K |
| 90834 |
Psychotherapy, 45 minutes with patient |
7,297 |
5,797 |
$473K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
10,175 |
6,882 |
$415K |
| H0006 |
Alcohol and/or drug services; case management |
7,600 |
5,221 |
$279K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,349 |
3,842 |
$267K |
| T1002 |
Rn services, up to 15 minutes |
6,833 |
6,310 |
$215K |
| 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) |
3,735 |
1,274 |
$205K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
5,900 |
3,624 |
$170K |
| 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 |
1,289 |
247 |
$148K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
1,508 |
1,130 |
$104K |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
6,235 |
1,028 |
$99K |
| J3490 |
Unclassified drugs |
333 |
297 |
$93K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
58 |
43 |
$62K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,050 |
939 |
$43K |
| 90791 |
Psychiatric diagnostic evaluation |
448 |
429 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
175 |
172 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
294 |
279 |
$26K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
3,378 |
3,149 |
$20K |
| J0575 |
Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine |
1,623 |
199 |
$19K |
| J0572 |
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
1,437 |
182 |
$17K |
| H0038 |
Self-help/peer services, per 15 minutes |
280 |
170 |
$9K |
| G2078 |
Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
1,434 |
799 |
$8K |
| G2074 |
Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
126 |
69 |
$6K |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
138 |
85 |
$5K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
196 |
191 |
$5K |
| H0001 |
Alcohol and/or drug assessment |
63 |
59 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
252 |
241 |
$4K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
91 |
89 |
$4K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
41 |
38 |
$4K |
| 86580 |
|
292 |
281 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
63 |
45 |
$1K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
50 |
45 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
131 |
128 |
$281.76 |
| 93000 |
|
15 |
15 |
$191.72 |
| 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 |
13 |
12 |
$47.66 |
| S9453 |
Smoking cessation classes, non-physician provider, per session |
15 |
12 |
$0.00 |