| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0100 |
Non-emergency transportation; taxi |
3,654,081 |
360,975 |
$70.64M |
| S0215 |
Non-emergency transportation; mileage, per mile |
2,728,265 |
306,640 |
$39.98M |
| A0130 |
Non-emergency transportation: wheelchair van |
350,305 |
35,459 |
$13.08M |
| S5131 |
Homemaker service, nos; per diem |
19,031 |
5,594 |
$7.07M |
| T2003 |
Non-emergency transportation; encounter/trip |
85,361 |
7,689 |
$6.05M |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
62,232 |
27,645 |
$4.97M |
| S5130 |
Homemaker service, nos; per 15 minutes |
23,834 |
7,485 |
$4.48M |
| S0209 |
Wheelchair van, mileage, per mile |
276,850 |
31,845 |
$4.44M |
| S5170 |
Home delivered meals, including preparation; per meal |
279,115 |
19,217 |
$3.66M |
| T2005 |
Non-emergency transportation; stretcher van |
15,254 |
1,445 |
$2.99M |
| S5175 |
Laundry service, external, professional; per order |
42,049 |
17,589 |
$2.23M |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
14,453 |
9,086 |
$1.78M |
| S5140 |
Foster care, adult; per diem |
3,562 |
501 |
$1.19M |
| S5121 |
Chore services; per diem |
10,425 |
3,878 |
$1.14M |
| S5102 |
Day care services, adult; per diem |
3,900 |
1,079 |
$1.03M |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
38,065 |
32,816 |
$946K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,342 |
10,737 |
$715K |
| 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) |
5,766 |
2,071 |
$711K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
3,011 |
692 |
$695K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
11,254 |
3,763 |
$660K |
| S5135 |
Companion care, adult (e.g., iadl/adl); per 15 minutes |
3,014 |
965 |
$528K |
| T2007 |
Transportation waiting time, air ambulance and non-emergency vehicle, one-half (1/2) hour increments |
9,371 |
4,369 |
$525K |
| A0180 |
Non-emergency transportation: ancillary: lodging-recipient |
3,678 |
2,975 |
$505K |
| H0046 |
Mental health services, not otherwise specified |
26,809 |
12,736 |
$443K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,251 |
4,472 |
$358K |
| T2001 |
Non-emergency transportation; patient attendant/escort |
32,540 |
7,695 |
$314K |
| T2049 |
Non-emergency transportation; stretcher van, mileage; per mile |
15,229 |
1,455 |
$301K |
| G0156 |
Services of home health/hospice aide in home health or hospice settings, each 15 minutes |
664 |
302 |
$290K |
| T2032 |
Residential care, not otherwise specified (nos), waiver; per month |
117 |
116 |
$283K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
2,076 |
1,765 |
$256K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
6,047 |
1,508 |
$210K |
| S5165 |
Home modifications; per service |
41 |
39 |
$188K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,543 |
931 |
$180K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,316 |
4,069 |
$165K |
| A0210 |
Non-emergency transportation: ancillary: meals-escort |
12,338 |
7,737 |
$155K |
| A0190 |
Non-emergency transportation: ancillary: meals-recipient |
3,358 |
2,457 |
$150K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,402 |
1,043 |
$148K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
2,667 |
1,920 |
$136K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
7,337 |
1,830 |
$128K |
| A0380 |
Bls mileage (per mile) |
1,760 |
274 |
$125K |
| 97124 |
|
2,866 |
470 |
$111K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,801 |
1,519 |
$106K |
| E0147 |
Walker, heavy duty, multiple braking system, variable wheel resistance |
891 |
877 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,022 |
992 |
$92K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
824 |
680 |
$78K |
| A0170 |
Transportation ancillary: parking fees, tolls, other |
14,802 |
6,371 |
$77K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
874 |
782 |
$72K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
738 |
696 |
$65K |
| A0425 |
Ground mileage, per statute mile |
2,482 |
1,987 |
$62K |
| H2010 |
Comprehensive medication services, per 15 minutes |
8,038 |
156 |
$57K |
| S5120 |
Chore services; per 15 minutes |
949 |
378 |
$52K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,885 |
810 |
$51K |
| 99401 |
|
1,767 |
1,467 |
$51K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
386 |
351 |
$43K |
| 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 |
334 |
279 |
$43K |
| 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 |
767 |
699 |
$39K |
| T2002 |
Non-emergency transportation; per diem |
7,744 |
1,210 |
$39K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
1,130 |
864 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
474 |
390 |
$36K |
| 90999 |
Unlisted dialysis procedure, inpatient or outpatient |
725 |
63 |
$33K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,017 |
901 |
$31K |
| S5160 |
Emergency response system; installation and testing |
786 |
742 |
$30K |
| 97535 |
Self-care/home management training, each 15 minutes |
1,075 |
320 |
$30K |
| E1399 |
Durable medical equipment, miscellaneous |
695 |
616 |
$26K |
| 97116 |
|
1,840 |
526 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
242 |
232 |
$23K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
233 |
217 |
$23K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
226 |
223 |
$22K |
| 93303 |
Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study |
155 |
142 |
$22K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,519 |
362 |
$22K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,140 |
1,023 |
$22K |
| T5999 |
Supply, not otherwise specified |
195 |
48 |
$20K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
86 |
84 |
$17K |
| 99354 |
|
193 |
178 |
$16K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
66 |
65 |
$16K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
90 |
90 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
187 |
178 |
$15K |
| 92587 |
|
893 |
856 |
$15K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
339 |
229 |
$13K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
188 |
139 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
689 |
669 |
$13K |
| E0245 |
Tub stool or bench |
1,190 |
1,162 |
$13K |
| 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 |
200 |
134 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
991 |
476 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
979 |
753 |
$11K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
175 |
37 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
293 |
258 |
$11K |
| V2020 |
Frames, purchases |
81 |
71 |
$11K |
| A4554 |
Disposable underpads, all sizes |
1,189 |
982 |
$10K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
228 |
166 |
$10K |
| 99058 |
|
568 |
515 |
$10K |
| A0200 |
Non-emergency transportation: ancillary: lodging escort |
87 |
67 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
78 |
66 |
$8K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
268 |
214 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
413 |
147 |
$7K |
| 93000 |
|
399 |
393 |
$6K |
| 92083 |
|
118 |
115 |
$6K |
| 99381 |
|
69 |
62 |
$6K |
| D1208 |
Topical application of fluoride, excluding varnish |
609 |
604 |
$6K |
| 93320 |
|
155 |
142 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
551 |
329 |
$5K |
| 92552 |
|
211 |
205 |
$5K |
| 94667 |
|
238 |
200 |
$5K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
314 |
264 |
$5K |
| 99188 |
|
424 |
421 |
$5K |
| 94760 |
|
1,761 |
1,593 |
$4K |
| E0156 |
Seat attachment, walker |
1,180 |
1,137 |
$4K |
| E0244 |
Raised toilet seat |
273 |
270 |
$4K |
| 99205 |
Prolong outpt/office vis |
26 |
25 |
$4K |
| 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 |
103 |
99 |
$4K |
| A4670 |
Automatic blood pressure monitor |
166 |
161 |
$4K |
| E0570 |
Nebulizer, with compressor |
250 |
244 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
555 |
503 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
80 |
46 |
$3K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
111 |
26 |
$3K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
214 |
210 |
$3K |
| E0241 |
Bath tub wall rail, each |
231 |
223 |
$3K |
| V2755 |
U-v lens, per lens |
80 |
66 |
$3K |
| 99243 |
|
36 |
34 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
210 |
158 |
$3K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
103 |
99 |
$3K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
38 |
38 |
$2K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
237 |
189 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
77 |
65 |
$2K |
| 93325 |
|
155 |
143 |
$2K |
| 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 |
111 |
110 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
322 |
322 |
$2K |
| E0246 |
Transfer tub rail attachment |
51 |
51 |
$2K |
| S9970 |
Health club membership, annual |
12 |
12 |
$2K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
138 |
123 |
$2K |
| 92567 |
|
121 |
111 |
$1K |
| 99306 |
Prolong nursin fac eval 15m |
25 |
25 |
$1K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
145 |
124 |
$1K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
49 |
38 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
132 |
42 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$966.96 |
| 81002 |
|
325 |
252 |
$932.19 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
62 |
53 |
$900.73 |
| E0305 |
Bed side rails, half length |
27 |
27 |
$869.16 |
| S5110 |
Home care training, family; per 15 minutes |
12 |
12 |
$796.29 |
| D1206 |
Topical application of fluoride varnish |
28 |
24 |
$795.00 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
102 |
97 |
$776.81 |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
12,979 |
560 |
$746.46 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
12 |
12 |
$698.88 |
| S9430 |
Pharmacy compounding and dispensing services |
130 |
129 |
$687.74 |
| 99305 |
|
16 |
15 |
$580.98 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
20 |
16 |
$513.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
20 |
12 |
$406.66 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
302 |
142 |
$374.71 |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
13 |
12 |
$354.09 |
| 83655 |
|
25 |
25 |
$353.00 |
| A7015 |
Aerosol mask, used with dme nebulizer |
222 |
185 |
$333.69 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$319.92 |
| 36416 |
|
73 |
65 |
$310.31 |
| 90674 |
|
13 |
13 |
$269.65 |
| 92015 |
Determination of refractive state |
34 |
33 |
$268.26 |
| 82962 |
|
181 |
159 |
$262.64 |
| E0210 |
Electric heat pad, standard |
13 |
13 |
$262.06 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
88 |
86 |
$233.42 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
46 |
46 |
$228.60 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
25 |
24 |
$227.27 |
| 97162 |
|
12 |
12 |
$219.24 |
| 85018 |
|
79 |
79 |
$217.25 |
| K0002 |
Standard hemi (low seat) wheelchair |
16 |
14 |
$179.79 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
113 |
113 |
$170.85 |
| 88740 |
|
114 |
77 |
$158.07 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
357 |
267 |
$157.65 |
| 90670 |
|
369 |
346 |
$125.54 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
42 |
42 |
$120.23 |
| H0049 |
Alcohol and/or drug screening |
12 |
12 |
$105.36 |
| A4245 |
Alcohol wipes, per box |
31 |
29 |
$68.79 |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
23 |
23 |
$57.62 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
42 |
39 |
$55.52 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
237 |
199 |
$54.48 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
118 |
105 |
$37.73 |
| 90686 |
|
805 |
787 |
$27.28 |
| 99177 |
|
14 |
14 |
$24.88 |
| 90651 |
|
106 |
95 |
$20.00 |
| 90734 |
|
74 |
62 |
$20.00 |
| 90688 |
|
89 |
88 |
$15.44 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
19 |
16 |
$10.68 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
107 |
91 |
$3.96 |
| A4335 |
Incontinence supply; miscellaneous |
36 |
30 |
$2.39 |
| 90461 |
|
166 |
157 |
$0.68 |
| 90680 |
|
180 |
165 |
$0.00 |
| 90716 |
|
47 |
39 |
$0.00 |
| 99000 |
|
27 |
25 |
$0.00 |
| 90698 |
|
171 |
163 |
$0.00 |
| 90656 |
|
40 |
40 |
$0.00 |
| E0248 |
Transfer bench, heavy duty, for tub or toilet with or without commode opening |
15 |
15 |
$0.00 |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
12 |
12 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
123 |
98 |
$0.00 |
| 90723 |
|
64 |
59 |
$0.00 |
| A6260 |
Wound cleansers, any type, any size |
28 |
24 |
$0.00 |
| 90744 |
|
42 |
39 |
$0.00 |
| 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 |
33 |
26 |
$0.00 |
| 0500F |
|
13 |
13 |
$0.00 |
| 90633 |
|
130 |
124 |
$0.00 |
| 99173 |
|
143 |
140 |
$0.00 |
| 90672 |
|
36 |
35 |
$0.00 |
| 90700 |
|
74 |
74 |
$0.00 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
36 |
31 |
$0.00 |
| 90707 |
|
70 |
62 |
$0.00 |
| 97810 |
|
145 |
61 |
$0.00 |
| 90715 |
|
21 |
17 |
$0.00 |
| 97813 |
|
79 |
28 |
$0.00 |
| 90713 |
|
45 |
45 |
$0.00 |
| 99442 |
|
21 |
19 |
$0.00 |
| 90648 |
|
85 |
80 |
$0.00 |
| 90685 |
|
52 |
49 |
$0.00 |
| 90710 |
|
31 |
26 |
$0.00 |
| 99499 |
|
15 |
13 |
$0.00 |
| 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) |
568 |
198 |
$0.00 |