| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73,672 |
64,033 |
$4.97M |
| T1016 |
Case management, each 15 minutes |
124,097 |
56,965 |
$4.53M |
| S9480 |
Intensive outpatient psychiatric services, per diem |
19,348 |
4,273 |
$3.31M |
| S5102 |
Day care services, adult; per diem |
11,093 |
7,641 |
$2.13M |
| 90791 |
Psychiatric diagnostic evaluation |
9,818 |
9,222 |
$1.73M |
| 90837 |
Psychotherapy, 53 minutes with patient |
16,964 |
10,013 |
$1.64M |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
43,637 |
38,614 |
$1.60M |
| 99490 |
Ccm add 20min |
35,292 |
31,832 |
$858K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
6,756 |
6,351 |
$613K |
| 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 |
4,405 |
819 |
$549K |
| T2001 |
Non-emergency transportation; patient attendant/escort |
31,225 |
8,281 |
$408K |
| 99215 |
Prolong outpt/office vis |
3,821 |
3,480 |
$358K |
| 99233 |
Prolong inpt eval add15 m |
3,706 |
1,290 |
$344K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,805 |
3,239 |
$323K |
| 99223 |
Prolong inpt eval add15 m |
1,737 |
1,635 |
$309K |
| Q3014 |
Telehealth originating site facility fee |
13,951 |
10,993 |
$273K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
6,393 |
3,161 |
$251K |
| 99495 |
|
3,282 |
182 |
$246K |
| H0043 |
Supported housing, per diem |
3,177 |
139 |
$233K |
| H2017 |
Psychosocial rehabilitation services, per 15 minutes |
3,035 |
763 |
$231K |
| H0047 |
Alcohol and/or other drug abuse services, not otherwise specified |
1,373 |
1,131 |
$226K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
7,083 |
6,592 |
$187K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
6,348 |
4,396 |
$142K |
| 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 |
3,499 |
2,493 |
$120K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,071 |
1,942 |
$105K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
794 |
763 |
$85K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,649 |
805 |
$80K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,507 |
1,247 |
$73K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
2,849 |
1,574 |
$72K |
| H2011 |
Crisis intervention service, per 15 minutes |
303 |
224 |
$59K |
| H0001 |
Alcohol and/or drug assessment |
569 |
522 |
$57K |
| H2014 |
Skills training and development, per 15 minutes |
1,290 |
338 |
$52K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,408 |
3,001 |
$40K |
| 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 |
764 |
487 |
$32K |
| 99205 |
Prolong outpt/office vis |
175 |
168 |
$29K |
| H0031 |
Mental health assessment, by non-physician |
197 |
180 |
$28K |
| 90868 |
|
132 |
12 |
$25K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,207 |
1,056 |
$19K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
310 |
291 |
$14K |
| 99306 |
Prolong nursin fac eval 15m |
130 |
121 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
118 |
111 |
$11K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
151 |
149 |
$10K |
| 82075 |
|
1,284 |
1,045 |
$9K |
| 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 |
104 |
72 |
$8K |
| 86580 |
|
1,759 |
1,537 |
$6K |
| 99310 |
Prolong nursin fac eval 15m |
76 |
73 |
$4K |
| G0506 |
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) |
148 |
135 |
$4K |
| 90839 |
|
34 |
32 |
$3K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
153 |
54 |
$3K |
| 98966 |
|
859 |
758 |
$3K |
| H0034 |
Medication training and support, per 15 minutes |
149 |
143 |
$2K |
| 99350 |
Prolong home eval add 15m |
47 |
32 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$2K |
| 90836 |
|
41 |
41 |
$1K |
| 99407 |
|
174 |
156 |
$1K |
| 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 |
26 |
21 |
$1K |
| 99328 |
|
14 |
12 |
$928.94 |
| 99345 |
Prolong home eval add 15m |
12 |
12 |
$794.48 |
| 80305 |
|
408 |
367 |
$774.92 |
| 36415 |
Collection of venous blood by venipuncture |
203 |
184 |
$668.74 |
| 99349 |
|
44 |
37 |
$576.17 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20 |
20 |
$570.00 |
| 81025 |
|
111 |
93 |
$393.12 |
| 99439 |
|
13 |
12 |
$247.50 |
| 99406 |
|
14 |
13 |
$131.81 |
| 80306 |
|
387 |
371 |
$119.76 |
| 98967 |
|
32 |
27 |
$116.34 |
| 82962 |
|
55 |
48 |
$62.38 |
| H0049 |
Alcohol and/or drug screening |
71 |
69 |
$48.75 |
| J0401 |
Injection, aripiprazole (abilify maintena), 1 mg |
466 |
432 |
$7.08 |
| J2426 |
Injection, paliperidone palmitate extended release (invega sustenna), 1 mg |
817 |
717 |
$0.17 |
| 4000F |
|
22 |
19 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
22 |
14 |
$0.00 |
| 3008F |
|
95 |
72 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
17 |
13 |
$0.00 |
| 1034F |
|
25 |
20 |
$0.00 |
| 3074F |
|
69 |
55 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
19 |
16 |
$0.00 |
| 3079F |
|
13 |
13 |
$0.00 |
| 90863 |
|
279 |
130 |
$0.00 |
| H0010 |
Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) |
136 |
133 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
34 |
27 |
$0.00 |
| 3078F |
|
51 |
44 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
79 |
63 |
$0.00 |