| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0019 |
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem |
116,836 |
7,865 |
$27.60M |
| H0033 |
Oral medication administration, direct observation |
856,009 |
79,111 |
$8.94M |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
863,132 |
73,800 |
$7.19M |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
143,202 |
53,363 |
$6.65M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
104,506 |
65,884 |
$5.75M |
| H0048 |
Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
220,424 |
98,870 |
$5.11M |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
232,321 |
11,087 |
$3.20M |
| T1020 |
Personal care services, per diem, 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) |
834 |
467 |
$3.20M |
| H0010 |
Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) |
2,518 |
832 |
$2.53M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,382 |
9,197 |
$1.52M |
| H0001 |
Alcohol and/or drug assessment |
9,495 |
9,231 |
$1.44M |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
776 |
701 |
$1.16M |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
161,936 |
11,681 |
$899K |
| J0572 |
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
106,035 |
6,876 |
$865K |
| T1007 |
Alcohol and/or substance abuse services, treatment plan development and/or modification |
8,053 |
7,536 |
$824K |
| 90887 |
|
9,994 |
5,508 |
$786K |
| 99205 |
Prolong outpt/office vis |
2,893 |
2,834 |
$669K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,959 |
5,461 |
$590K |
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
4,196 |
3,368 |
$406K |
| H0038 |
Self-help/peer services, per 15 minutes |
4,214 |
2,371 |
$266K |
| H0006 |
Alcohol and/or drug services; case management |
4,620 |
3,020 |
$241K |
| H2010 |
Comprehensive medication services, per 15 minutes |
10,347 |
4,689 |
$237K |
| 99215 |
Prolong outpt/office vis |
1,242 |
1,207 |
$223K |
| 97810 |
|
10,977 |
5,401 |
$139K |
| 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) |
11,952 |
3,925 |
$139K |
| J0575 |
Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine |
5,765 |
556 |
$101K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
2,060 |
358 |
$90K |
| J3490 |
Unclassified drugs |
11,288 |
632 |
$85K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
254 |
243 |
$56K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
981 |
939 |
$32K |
| 97811 |
|
2,877 |
1,389 |
$32K |
| T1016 |
Case management, each 15 minutes |
221 |
164 |
$17K |
| G2215 |
Take-home supply of nasal naloxone; 2-pack of 4mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure |
140 |
134 |
$12K |
| H2014 |
Skills training and development, per 15 minutes |
267 |
63 |
$9K |
| H0034 |
Medication training and support, per 15 minutes |
198 |
188 |
$5K |
| 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 |
3,172 |
1,287 |
$3K |
| J0573 |
Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine |
1,063 |
126 |
$2K |
| G9012 |
Other specified case management service not elsewhere classified |
26 |
25 |
$600.71 |
| 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 |
72 |
59 |
$145.00 |
| G2172 |
All inclusive payment for services related to highly coordinated and integrated opioid use disorder (oud) treatment services furnished for the demonstration project |
28 |
16 |
$0.00 |