| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2016 |
Habilitation, residential, waiver; per diem |
883 |
756 |
$3.67M |
| T1017 |
Targeted case management, each 15 minutes |
14,061 |
12,652 |
$2.23M |
| T2021 |
Day habilitation, waiver; per 15 minutes |
3,370 |
2,297 |
$1.59M |
| T2019 |
Habilitation, supported employment, waiver; per 15 minutes |
1,304 |
1,075 |
$791K |
| T2003 |
Non-emergency transportation; encounter/trip |
2,159 |
1,802 |
$260K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
742 |
362 |
$232K |
| T2004 |
Non-emergency transport; commercial carrier, multi-pass |
3,500 |
2,793 |
$121K |
| H2021 |
Community-based wrap-around services, per 15 minutes |
955 |
816 |
$102K |
| T1019 |
Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) |
839 |
649 |
$69K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
426 |
342 |
$25K |
| V2799 |
Vision item or service, miscellaneous |
107 |
96 |
$20K |
| S5130 |
Homemaker service, nos; per 15 minutes |
66 |
46 |
$8K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
14 |
13 |
$679.00 |