| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2023 |
Targeted case management; per month |
13,435 |
12,062 |
$3.92M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
84,506 |
31,909 |
$3.64M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
77,930 |
36,988 |
$2.94M |
| 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 |
18,641 |
7,135 |
$2.49M |
| 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 |
12,261 |
9,848 |
$1.51M |
| 90832 |
Psychotherapy, 30 minutes with patient |
34,590 |
18,376 |
$1.16M |
| 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 |
14,497 |
9,009 |
$1.15M |
| 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 |
6,836 |
4,280 |
$649K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
29,221 |
14,712 |
$400K |
| G0659 |
Drug test(s), definitive, utilizing 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), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes |
5,975 |
2,202 |
$344K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,331 |
3,499 |
$251K |
| H0038 |
Self-help/peer services, per 15 minutes |
16,705 |
8,401 |
$250K |
| T1007 |
Alcohol and/or substance abuse services, treatment plan development and/or modification |
2,743 |
2,673 |
$221K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
3,179 |
2,120 |
$135K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
791 |
689 |
$72K |
| H0001 |
Alcohol and/or drug assessment |
523 |
514 |
$44K |
| 90837 |
Psychotherapy, 53 minutes with patient |
464 |
378 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,208 |
842 |
$29K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
197 |
192 |
$23K |
| 90791 |
Psychiatric diagnostic evaluation |
318 |
260 |
$23K |
| 90834 |
Psychotherapy, 45 minutes with patient |
194 |
150 |
$10K |
| 80306 |
|
896 |
541 |
$10K |
| 99385 |
|
105 |
82 |
$3K |
| 90838 |
|
42 |
25 |
$1K |
| 99406 |
|
132 |
103 |
$948.24 |
| 80361 |
|
36 |
12 |
$682.38 |
| 80363 |
|
36 |
12 |
$682.38 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
60 |
43 |
$495.88 |
| 90756 |
|
29 |
26 |
$466.97 |
| 80348 |
|
39 |
12 |
$412.18 |
| 80344 |
|
39 |
12 |
$412.18 |
| 80355 |
|
39 |
12 |
$412.18 |
| 80325 |
|
39 |
12 |
$412.18 |
| 80354 |
|
39 |
12 |
$412.18 |
| 80356 |
|
39 |
12 |
$412.18 |
| 80349 |
|
39 |
12 |
$412.18 |
| 80365 |
|
36 |
12 |
$378.76 |
| 80360 |
|
36 |
12 |
$378.76 |
| 80353 |
|
36 |
12 |
$378.76 |
| 80368 |
|
36 |
12 |
$378.76 |
| 80358 |
|
36 |
12 |
$378.76 |
| H0049 |
Alcohol and/or drug screening |
105 |
83 |
$378.00 |
| 99386 |
|
12 |
12 |
$350.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
21 |
$316.52 |
| 80377 |
|
29 |
12 |
$300.78 |
| 81002 |
|
182 |
141 |
$249.41 |
| 96103 |
|
29 |
21 |
$206.98 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
58 |
49 |
$112.10 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
14,423 |
6,915 |
$31.24 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
23 |
14 |
$0.78 |
| G9578 |
Documentation of signed opioid treatment agreement at least once during opioid therapy |
14 |
12 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
136 |
104 |
$0.00 |
| G8938 |
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
55 |
41 |
$0.00 |
| G0436 |
Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes |
36 |
34 |
$0.00 |