| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0481 |
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; 8-14 drug class(es), including metabolite(s) if performed |
28,376 |
18,067 |
$3.25M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40,898 |
20,591 |
$1.89M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41,209 |
28,864 |
$1.85M |
| T1007 |
Alcohol and/or substance abuse services, treatment plan development and/or modification |
32,026 |
18,254 |
$1.81M |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
11,791 |
7,932 |
$1.67M |
| 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 |
16,935 |
13,929 |
$1.52M |
| G0483 |
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; 22 or more drug class(es), including metabolite(s) if performed |
8,246 |
5,395 |
$1.43M |
| H0001 |
Alcohol and/or drug assessment |
23,308 |
16,956 |
$1.38M |
| H2027 |
Psychoeducational service, per 15 minutes |
20,399 |
12,576 |
$790K |
| 99215 |
Prolong outpt/office vis |
11,589 |
6,267 |
$732K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
12,263 |
8,360 |
$642K |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
46,931 |
21,522 |
$591K |
| 80305 |
|
56,838 |
31,878 |
$560K |
| H0031 |
Mental health assessment, by non-physician |
9,123 |
5,988 |
$448K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
15,164 |
8,292 |
$444K |
| 90832 |
Psychotherapy, 30 minutes with patient |
16,420 |
10,191 |
$434K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
9,055 |
4,565 |
$392K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
36,422 |
18,280 |
$388K |
| H0049 |
Alcohol and/or drug screening |
16,320 |
10,739 |
$261K |
| 99408 |
|
23,947 |
11,797 |
$257K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
3,566 |
3,058 |
$242K |
| H2011 |
Crisis intervention service, per 15 minutes |
15,029 |
8,265 |
$228K |
| 90785 |
|
37,599 |
16,816 |
$212K |
| H0032 |
Mental health service plan development by non-physician |
3,126 |
2,526 |
$170K |
| 96156 |
|
5,712 |
3,185 |
$142K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
2,625 |
2,175 |
$133K |
| 90791 |
Psychiatric diagnostic evaluation |
3,057 |
2,271 |
$130K |
| T2023 |
Targeted case management; per month |
366 |
357 |
$127K |
| 99205 |
Prolong outpt/office vis |
1,572 |
1,120 |
$118K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
8,567 |
6,421 |
$112K |
| 80306 |
|
8,217 |
2,590 |
$102K |
| 81025 |
|
14,233 |
9,059 |
$101K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,071 |
1,782 |
$94K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,657 |
1,427 |
$85K |
| 99354 |
|
1,703 |
1,213 |
$74K |
| H0038 |
Self-help/peer services, per 15 minutes |
7,216 |
4,779 |
$72K |
| 96151 |
|
7,364 |
3,415 |
$64K |
| 87631 |
|
947 |
744 |
$52K |
| H2015 |
Comprehensive community support services, per 15 minutes |
1,491 |
791 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
588 |
491 |
$48K |
| 87563 |
|
1,670 |
1,435 |
$45K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,930 |
1,622 |
$43K |
| 99401 |
|
2,386 |
1,862 |
$39K |
| 97151 |
|
3,781 |
1,804 |
$39K |
| 93000 |
|
2,116 |
1,746 |
$32K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,039 |
1,805 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
453 |
410 |
$27K |
| 99406 |
|
4,516 |
3,560 |
$25K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
1,175 |
1,029 |
$23K |
| 99407 |
|
2,305 |
1,674 |
$21K |
| 90839 |
|
338 |
206 |
$20K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
738 |
620 |
$13K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
700 |
578 |
$13K |
| 86769 |
|
588 |
374 |
$10K |
| 96150 |
|
945 |
663 |
$7K |
| 0012A |
|
228 |
206 |
$7K |
| 0011A |
|
160 |
147 |
$5K |
| 90834 |
Psychotherapy, 45 minutes with patient |
93 |
76 |
$5K |
| 86318 |
|
505 |
422 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
111 |
100 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
2,158 |
1,672 |
$4K |
| 0031A |
|
125 |
115 |
$4K |
| 86632 |
|
314 |
287 |
$3K |
| 86631 |
|
313 |
286 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
98 |
37 |
$2K |
| 99386 |
|
16 |
14 |
$2K |
| 0034A |
|
43 |
39 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$1K |
| 0013A |
|
33 |
31 |
$960.00 |
| 99484 |
|
48 |
26 |
$891.38 |
| 90887 |
|
55 |
30 |
$869.04 |
| 96127 |
|
527 |
442 |
$823.20 |
| 90875 |
|
1,402 |
952 |
$729.31 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
33 |
28 |
$127.21 |
| 86635 |
|
17 |
14 |
$104.61 |
| 86602 |
|
17 |
14 |
$92.82 |
| G2087 |
Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month |
25 |
24 |
$81.36 |
| 94760 |
|
36 |
31 |
$51.31 |
| 90863 |
|
806 |
551 |
$16.88 |
| 888888 |
|
274 |
258 |
$0.00 |
| 99072 |
|
1,054 |
946 |
$0.00 |
| T2024 |
Service assessment/plan of care development, waiver |
69 |
26 |
$0.00 |
| 97156 |
|
39 |
28 |
$0.00 |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
112 |
36 |
$0.00 |
| 99000 |
|
191 |
167 |
$0.00 |
| 97154 |
|
119 |
73 |
$0.00 |