| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1012 |
Alcohol and/or substance abuse services, skills development |
35,022 |
20,340 |
$12.32M |
| 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 |
40,213 |
23,717 |
$3.91M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
52,850 |
38,457 |
$3.54M |
| T1015 |
Clinic visit/encounter, all-inclusive |
6,323 |
3,433 |
$2.62M |
| 99215 |
Prolong outpt/office vis |
49,372 |
28,845 |
$1.68M |
| 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) |
8,276 |
2,875 |
$1.57M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
44,437 |
29,119 |
$1.48M |
| 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 |
14,551 |
13,429 |
$1.08M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,483 |
14,616 |
$1.01M |
| 90837 |
Psychotherapy, 53 minutes with patient |
13,164 |
8,245 |
$858K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
578 |
556 |
$670K |
| 90834 |
Psychotherapy, 45 minutes with patient |
11,820 |
8,057 |
$571K |
| G2068 |
Medication assisted treatment, buprenorphine (oral); 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) |
1,575 |
1,029 |
$361K |
| 90832 |
Psychotherapy, 30 minutes with patient |
10,862 |
7,999 |
$322K |
| 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 |
1,090 |
1,057 |
$150K |
| S0109 |
Methadone, oral, 5 mg |
442 |
50 |
$125K |
| 90791 |
Psychiatric diagnostic evaluation |
1,567 |
1,547 |
$121K |
| G2079 |
Take-home supply of buprenorphine (oral); 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 |
622 |
538 |
$68K |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
4,296 |
244 |
$63K |
| 99205 |
Prolong outpt/office vis |
579 |
577 |
$43K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
436 |
431 |
$40K |
| G2074 |
Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) |
116 |
97 |
$18K |
| J0571 |
Buprenorphine, oral, 1 mg |
1,104 |
44 |
$14K |
| 81025 |
|
2,010 |
1,696 |
$12K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
604 |
325 |
$11K |
| 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 |
228 |
154 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
810 |
781 |
$9K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
26 |
26 |
$2K |
| 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 |
19 |
13 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
37 |
37 |
$1K |
| H0033 |
Oral medication administration, direct observation |
70 |
41 |
$983.94 |
| 99406 |
|
99 |
83 |
$795.03 |