| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2031 |
Assisted living; waiver, per diem |
11,028 |
7,072 |
$17.13M |
| T2033 |
Residential care, not otherwise specified (nos), waiver; per diem |
1,428 |
800 |
$4.34M |
| T2030 |
Assisted living, waiver; per month |
2,039 |
1,648 |
$4.10M |
| E1392 |
Portable oxygen concentrator, rental |
13,566 |
10,956 |
$3.38M |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
22,739 |
17,287 |
$2.85M |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,936 |
1,633 |
$967K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
1,738 |
1,420 |
$719K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
30,826 |
18,576 |
$603K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,158 |
3,310 |
$347K |
| 97124 |
|
5,072 |
1,287 |
$326K |
| E1399 |
Durable medical equipment, miscellaneous |
2,450 |
1,546 |
$297K |
| V2799 |
Vision item or service, miscellaneous |
1,046 |
878 |
$272K |
| A0425 |
Ground mileage, per statute mile |
4,998 |
3,794 |
$205K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
573 |
459 |
$155K |
| H2018 |
Psychosocial rehabilitation services, per diem |
327 |
222 |
$146K |
| 71046 |
Radiologic examination, chest; 2 views |
581 |
542 |
$144K |
| 97813 |
|
1,322 |
318 |
$138K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
2,062 |
601 |
$122K |
| 98940 |
|
2,176 |
691 |
$115K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,661 |
3,409 |
$108K |
| 11056 |
|
1,477 |
1,438 |
$107K |
| 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) |
762 |
614 |
$102K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,599 |
1,478 |
$98K |
| 11721 |
|
2,006 |
1,944 |
$89K |
| 97012 |
|
3,722 |
1,019 |
$77K |
| 84443 |
Thyroid stimulating hormone (TSH) |
4,160 |
3,841 |
$69K |
| 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 |
585 |
537 |
$67K |
| 98960 |
|
979 |
487 |
$64K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
2,623 |
868 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
467 |
444 |
$60K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
81 |
67 |
$58K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
7,194 |
6,478 |
$55K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,568 |
5,166 |
$54K |
| 82607 |
|
3,468 |
3,220 |
$52K |
| 80061 |
Lipid panel |
3,634 |
3,377 |
$48K |
| 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 |
207 |
188 |
$46K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
581 |
348 |
$46K |
| 80053 |
Comprehensive metabolic panel |
4,125 |
3,721 |
$43K |
| V5261 |
Hearing aid, digital, binaural, bte |
20 |
12 |
$42K |
| 82728 |
|
3,052 |
2,818 |
$41K |
| L2999 |
Lower extremity orthoses, not otherwise specified |
134 |
128 |
$39K |
| 97026 |
|
1,449 |
357 |
$36K |
| 93000 |
|
240 |
227 |
$36K |
| 11057 |
|
482 |
471 |
$35K |
| A4615 |
Cannula, nasal |
2,387 |
1,688 |
$35K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
214 |
203 |
$35K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
4,058 |
3,620 |
$34K |
| A0130 |
Non-emergency transportation: wheelchair van |
17,094 |
3,788 |
$33K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
283 |
265 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,873 |
1,680 |
$30K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
203 |
170 |
$29K |
| 97810 |
|
1,009 |
320 |
$28K |
| 83550 |
|
3,086 |
2,846 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,350 |
3,899 |
$25K |
| 83970 |
|
591 |
555 |
$24K |
| 83540 |
|
3,091 |
2,849 |
$20K |
| 97014 |
|
876 |
254 |
$16K |
| D9986 |
|
394 |
269 |
$13K |
| E1353 |
Regulator |
1,105 |
900 |
$12K |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
1,180 |
901 |
$11K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
30 |
29 |
$11K |
| A0120 |
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems |
22,110 |
2,390 |
$10K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
56 |
55 |
$10K |
| 99348 |
|
158 |
147 |
$10K |
| D9987 |
|
184 |
147 |
$10K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
63 |
60 |
$9K |
| 86803 |
|
626 |
584 |
$9K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
956 |
859 |
$8K |
| G0471 |
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) |
1,060 |
763 |
$7K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
480 |
202 |
$7K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
392 |
103 |
$7K |
| 87088 |
|
825 |
742 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
2,103 |
1,895 |
$6K |
| 99439 |
|
64 |
64 |
$6K |
| A4616 |
Tubing (oxygen), per foot |
637 |
520 |
$5K |
| V2020 |
Frames, purchases |
68 |
62 |
$5K |
| 82570 |
|
866 |
806 |
$4K |
| 99490 |
Ccm add 20min |
64 |
64 |
$4K |
| G3002 |
Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care, e.g. physical therapy and occupational therapy, complementary and integrative approaches, and community-based care, as appropriate. required initial face-to-face visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (when using g3002, 30 minutes must be met or exceeded.) |
48 |
34 |
$4K |
| 84439 |
|
360 |
316 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
82 |
80 |
$3K |
| 85027 |
|
483 |
411 |
$3K |
| D0330 |
Panoramic radiographic image |
59 |
56 |
$3K |
| 83880 |
|
74 |
66 |
$3K |
| 87186 |
|
322 |
290 |
$3K |
| G3003 |
Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.) |
48 |
34 |
$3K |
| 99307 |
|
412 |
374 |
$3K |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
557 |
436 |
$3K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
13 |
13 |
$3K |
| 84156 |
|
690 |
635 |
$3K |
| 87077 |
|
305 |
273 |
$3K |
| 84153 |
|
122 |
102 |
$2K |
| 81003 |
|
913 |
816 |
$2K |
| 84100 |
|
402 |
385 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
236 |
38 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
55 |
54 |
$2K |
| A0999 |
Unlisted ambulance service |
13,217 |
2,943 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,434 |
917 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
139 |
113 |
$2K |
| 82248 |
|
257 |
240 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
13 |
12 |
$1K |
| 81001 |
|
323 |
305 |
$1K |
| 83735 |
|
156 |
146 |
$1K |
| 77080 |
|
28 |
28 |
$945.17 |
| D0230 |
Intraoral - periapical each additional radiographic image |
67 |
20 |
$867.65 |
| 90694 |
|
12 |
12 |
$797.16 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,579 |
558 |
$794.00 |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
78 |
12 |
$735.00 |
| 80299 |
|
30 |
25 |
$559.20 |
| 82652 |
|
14 |
12 |
$539.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
1,212 |
1,043 |
$514.58 |
| 92015 |
Determination of refractive state |
54 |
49 |
$450.40 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
147 |
12 |
$436.81 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$411.70 |
| 82746 |
|
27 |
26 |
$396.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$380.00 |
| S0209 |
Wheelchair van, mileage, per mile |
31 |
13 |
$213.40 |
| G0008 |
Administration of influenza virus vaccine |
153 |
153 |
$210.36 |
| 80069 |
|
23 |
14 |
$199.64 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
23 |
12 |
$51.31 |
| G9012 |
Other specified case management service not elsewhere classified |
10,077 |
6,198 |
$0.00 |
| T1002 |
Rn services, up to 15 minutes |
4,015 |
2,610 |
$0.00 |
| S5120 |
Chore services; per 15 minutes |
15,258 |
5,261 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
423 |
377 |
$0.00 |
| 99417 |
Prolong home eval add 15m |
43 |
43 |
$0.00 |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
2,396 |
1,267 |
$0.00 |
| T1016 |
Case management, each 15 minutes |
3,280 |
2,463 |
$0.00 |
| S5101 |
Day care services, adult; per half day |
51,673 |
14,143 |
$0.00 |
| 97802 |
|
104 |
97 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
556 |
499 |
$0.00 |
| A4215 |
Needle, sterile, any size, each |
88 |
76 |
$0.00 |
| A0398 |
Als routine disposable supplies |
976 |
640 |
$0.00 |
| 96151 |
|
310 |
276 |
$0.00 |
| S5125 |
Attendant care services; per 15 minutes |
2,926 |
757 |
$0.00 |
| 99305 |
|
83 |
74 |
$0.00 |
| 99000 |
|
396 |
351 |
$0.00 |
| 99443 |
|
85 |
81 |
$0.00 |
| 98967 |
|
14 |
12 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
65 |
45 |
$0.00 |
| 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) |
189 |
109 |
$0.00 |
| A6260 |
Wound cleansers, any type, any size |
210 |
73 |
$0.00 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
61 |
41 |
$0.00 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
192 |
171 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
93 |
27 |
$0.00 |
| S9097 |
Home visit for wound care |
193 |
71 |
$0.00 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
104 |
58 |
$0.00 |
| 96156 |
|
64 |
64 |
$0.00 |
| 97162 |
|
70 |
68 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
15 |
12 |
$0.00 |
| 96150 |
|
14 |
13 |
$0.00 |
| E0130 |
Walker, rigid (pickup), adjustable or fixed height |
23 |
15 |
$0.00 |
| 99441 |
|
23 |
20 |
$0.00 |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
7,276 |
4,363 |
$0.00 |
| S5130 |
Homemaker service, nos; per 15 minutes |
42,190 |
10,009 |
$0.00 |
| T1003 |
Lpn/lvn services, up to 15 minutes |
868 |
602 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
405 |
373 |
$0.00 |
| A0422 |
Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation |
462 |
409 |
$0.00 |
| 11719 |
|
688 |
671 |
$0.00 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
48 |
16 |
$0.00 |
| 96160 |
|
497 |
471 |
$0.00 |
| S5170 |
Home delivered meals, including preparation; per meal |
3,181 |
1,939 |
$0.00 |
| 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 |
1,832 |
1,435 |
$0.00 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
174 |
157 |
$0.00 |
| 3288F |
|
70 |
52 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
356 |
299 |
$0.00 |
| 96152 |
|
343 |
302 |
$0.00 |
| 99497 |
|
41 |
41 |
$0.00 |
| A0382 |
Bls routine disposable supplies |
305 |
230 |
$0.00 |
| 98966 |
|
213 |
168 |
$0.00 |
| S9123 |
Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) |
296 |
266 |
$0.00 |
| 90653 |
|
142 |
142 |
$0.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
164 |
114 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
442 |
200 |
$0.00 |
| 99442 |
|
30 |
28 |
$0.00 |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
28 |
13 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24 |
24 |
$0.00 |
| 93041 |
|
31 |
24 |
$0.00 |
| V5266 |
Battery for use in hearing device |
60 |
56 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
17 |
12 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
13 |
13 |
$0.00 |
| 96158 |
|
31 |
31 |
$0.00 |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
29 |
13 |
$0.00 |