| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
254,666 |
105,920 |
$40.24M |
| S5000 |
Prescription drug, generic |
300,394 |
94,958 |
$40.02M |
| S5001 |
Prescription drug, brand name |
26,432 |
9,596 |
$6.03M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
94,157 |
52,349 |
$5.50M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
41,208 |
37,452 |
$4.83M |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
92,654 |
59,873 |
$4.12M |
| H0015 |
Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education |
24,180 |
5,720 |
$4.03M |
| 90837 |
Psychotherapy, 53 minutes with patient |
38,543 |
24,774 |
$3.89M |
| 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 |
30,857 |
24,068 |
$3.69M |
| H0048 |
Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
250,483 |
141,288 |
$3.57M |
| J0574 |
Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine |
203,501 |
81,645 |
$3.21M |
| 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 |
32,844 |
23,315 |
$2.30M |
| 90834 |
Psychotherapy, 45 minutes with patient |
26,193 |
19,761 |
$1.80M |
| 90832 |
Psychotherapy, 30 minutes with patient |
33,947 |
24,780 |
$1.80M |
| J3490 |
Unclassified drugs |
6,888 |
6,156 |
$756K |
| J0572 |
Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine |
53,419 |
23,765 |
$596K |
| J0571 |
Buprenorphine, oral, 1 mg |
26,880 |
10,036 |
$450K |
| 99205 |
Prolong outpt/office vis |
1,621 |
1,573 |
$326K |
| T1003 |
Lpn/lvn services, up to 15 minutes |
12,594 |
11,375 |
$277K |
| 80362 |
|
16,700 |
11,967 |
$269K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
4,496 |
1,085 |
$234K |
| 80348 |
|
23,506 |
16,550 |
$210K |
| 80354 |
|
23,420 |
16,508 |
$209K |
| J0575 |
Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine |
18,210 |
10,956 |
$180K |
| 80346 |
|
11,872 |
7,112 |
$166K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,915 |
1,767 |
$152K |
| 99215 |
Prolong outpt/office vis |
882 |
833 |
$131K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
94 |
86 |
$118K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,604 |
3,429 |
$91K |
| 80364 |
|
5,437 |
4,883 |
$89K |
| T1002 |
Rn services, up to 15 minutes |
2,446 |
1,785 |
$83K |
| H0006 |
Alcohol and/or drug services; case management |
1,317 |
728 |
$49K |
| 80365 |
|
5,316 |
4,836 |
$48K |
| 80335 |
|
4,847 |
4,469 |
$44K |
| 80338 |
|
4,781 |
4,411 |
$44K |
| 80342 |
|
4,723 |
4,361 |
$43K |
| 80360 |
|
4,785 |
4,419 |
$43K |
| 80357 |
|
4,733 |
4,381 |
$43K |
| 80369 |
|
4,708 |
4,354 |
$43K |
| 80373 |
|
4,695 |
4,343 |
$43K |
| 80368 |
|
4,701 |
4,347 |
$43K |
| 80358 |
|
4,534 |
4,152 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
212 |
193 |
$38K |
| J2310 |
Injection, naloxone hydrochloride, per 1 mg |
298 |
253 |
$31K |
| 80349 |
|
2,821 |
2,236 |
$26K |
| 82075 |
|
1,358 |
823 |
$25K |
| 80324 |
|
2,687 |
2,023 |
$25K |
| 36415 |
Collection of venous blood by venipuncture |
9,460 |
8,780 |
$25K |
| 90791 |
Psychiatric diagnostic evaluation |
211 |
197 |
$20K |
| H0038 |
Self-help/peer services, per 15 minutes |
1,697 |
381 |
$19K |
| 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) |
827 |
462 |
$10K |
| H0001 |
Alcohol and/or drug assessment |
215 |
127 |
$9K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
122 |
119 |
$7K |
| 81025 |
|
1,566 |
1,295 |
$7K |
| 90785 |
|
573 |
393 |
$7K |
| 80353 |
|
685 |
537 |
$6K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
210 |
97 |
$5K |
| 86580 |
|
1,040 |
942 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
175 |
150 |
$4K |
| 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 |
19 |
14 |
$2K |
| J0573 |
Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine |
709 |
308 |
$2K |
| 80359 |
|
157 |
140 |
$1K |
| 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) |
100 |
52 |
$717.12 |
| 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 |
496 |
232 |
$406.63 |
| 83992 |
|
27 |
25 |
$378.25 |
| 80367 |
|
12 |
12 |
$113.53 |
| J0578 |
Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy |
12 |
12 |
$0.00 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
13 |
12 |
$0.00 |