| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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) |
1,162,388 |
61,490 |
$69.52M |
| T1021 |
Home health aide or certified nurse assistant, per visit |
2,212,926 |
52,254 |
$39.54M |
| S5130 |
Homemaker service, nos; per 15 minutes |
781,704 |
59,267 |
$27.83M |
| S5150 |
Unskilled respite care, not hospice; per 15 minutes |
196,046 |
10,336 |
$12.72M |
| S5135 |
Companion care, adult (e.g., iadl/adl); per 15 minutes |
196,936 |
10,617 |
$7.11M |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
6,354 |
4,298 |
$2.53M |
| E1399 |
Durable medical equipment, miscellaneous |
4,234 |
2,565 |
$2.13M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
3,576 |
3,365 |
$1.99M |
| E1392 |
Portable oxygen concentrator, rental |
8,830 |
8,061 |
$1.92M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
2,200 |
2,113 |
$1.40M |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,353 |
937 |
$840K |
| B9998 |
Noc for enteral supplies |
16,409 |
11,231 |
$785K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
6,707 |
4,253 |
$773K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
18,906 |
1,285 |
$749K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
17,034 |
1,212 |
$694K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
18,357 |
1,113 |
$666K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
6,206 |
5,274 |
$539K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
6,382 |
5,380 |
$467K |
| S9131 |
Physical therapy; in the home, per diem |
5,130 |
1,146 |
$448K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
833 |
660 |
$409K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,571 |
4,143 |
$404K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
938 |
654 |
$255K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,212 |
1,524 |
$233K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,069 |
1,826 |
$232K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,181 |
985 |
$198K |
| S9128 |
Speech therapy, in the home, per diem |
1,670 |
226 |
$124K |
| S9129 |
Occupational therapy, in the home, per diem |
1,652 |
354 |
$110K |
| 97163 |
|
548 |
423 |
$104K |
| E0570 |
Nebulizer, with compressor |
3,007 |
2,771 |
$103K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
481 |
243 |
$84K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
1,407 |
1,027 |
$83K |
| K0001 |
Standard wheelchair |
5,036 |
4,581 |
$81K |
| K0008 |
Custom manual wheelchair/base |
17 |
12 |
$73K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,094 |
3,276 |
$54K |
| E0277 |
Powered pressure-reducing air mattress |
653 |
556 |
$49K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
349 |
330 |
$48K |
| T1001 |
Nursing assessment / evaluation |
480 |
449 |
$44K |
| A4554 |
Disposable underpads, all sizes |
680 |
465 |
$44K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,340 |
3,045 |
$37K |
| T1002 |
Rn services, up to 15 minutes |
369 |
25 |
$33K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
224 |
169 |
$31K |
| T1030 |
Nursing care, in the home, by registered nurse, per diem |
387 |
290 |
$31K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
315 |
241 |
$27K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
538 |
526 |
$25K |
| B9002 |
Enteral nutrition infusion pump, any type |
747 |
652 |
$22K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
489 |
431 |
$19K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
431 |
358 |
$11K |
| A4623 |
Tracheostomy, inner cannula |
187 |
166 |
$8K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,409 |
4,572 |
$7K |
| K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
559 |
482 |
$7K |
| K0003 |
Lightweight wheelchair |
156 |
150 |
$6K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,578 |
1,134 |
$6K |
| 97161 |
|
30 |
25 |
$6K |
| 97166 |
|
110 |
85 |
$6K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
564 |
467 |
$5K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
981 |
792 |
$5K |
| 97162 |
|
15 |
14 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
206 |
145 |
$4K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
680 |
572 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
320 |
264 |
$4K |
| A5120 |
Skin barrier, wipes or swabs, each |
910 |
763 |
$3K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
14 |
12 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
58 |
50 |
$3K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
31 |
30 |
$3K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
228 |
206 |
$3K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
162 |
142 |
$2K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
30 |
29 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
180 |
150 |
$2K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
50 |
48 |
$2K |
| K0813 |
Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds |
32 |
24 |
$2K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
109 |
101 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
112 |
106 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
104 |
100 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
31 |
30 |
$855.92 |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
28 |
26 |
$759.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
207 |
189 |
$743.09 |
| A7002 |
Tubing, used with suction pump, each |
75 |
53 |
$647.26 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
476 |
447 |
$468.49 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
159 |
142 |
$441.99 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
351 |
327 |
$408.03 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
175 |
141 |
$396.89 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
65 |
65 |
$268.68 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
38 |
36 |
$256.46 |
| E0156 |
Seat attachment, walker |
284 |
236 |
$254.67 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
41 |
39 |
$155.71 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
13 |
12 |
$155.29 |
| A7035 |
Headgear used with positive airway pressure device |
26 |
25 |
$152.84 |
| A7000 |
Canister, disposable, used with suction pump, each |
35 |
30 |
$116.29 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
76 |
38 |
$47.08 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
30 |
27 |
$29.00 |
| E0776 |
Iv pole |
14 |
12 |
$7.95 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
12 |
12 |
$5.76 |
| A7015 |
Aerosol mask, used with dme nebulizer |
83 |
81 |
$2.58 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
56 |
51 |
$0.00 |
| A6447 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard |
42 |
33 |
$0.00 |
| A4618 |
Breathing circuits |
49 |
47 |
$0.00 |
| 99601 |
|
31 |
12 |
$0.00 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
29 |
25 |
$0.00 |
| G0156 |
Services of home health/hospice aide in home health or hospice settings, each 15 minutes |
2,348 |
96 |
$0.00 |
| Q5002 |
Hospice or home health care provided in assisted living facility |
116 |
62 |
$0.00 |
| G0300 |
Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes |
3,122 |
149 |
$0.00 |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
456 |
167 |
$0.00 |
| Q5001 |
Hospice or home health care provided in patient's home/residence |
760 |
242 |
$0.00 |
| 84160 |
|
28 |
28 |
$0.00 |
| G0152 |
Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes |
48 |
21 |
$0.00 |
| G0151 |
Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes |
338 |
111 |
$0.00 |