| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0046 |
Mental health services, not otherwise specified |
4,233 |
277 |
$995K |
| T1026 |
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour |
1,828 |
479 |
$317K |
| 97153 |
Adaptive behavior treatment by protocol, administered by technician, each 15 minutes |
1,709 |
230 |
$309K |
| Q3014 |
Telehealth originating site facility fee |
2,736 |
604 |
$68K |
| 97155 |
Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes |
454 |
112 |
$48K |
| 90791 |
Psychiatric diagnostic evaluation |
78 |
78 |
$12K |