Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

Billing Codes in Alabama

All 2,793 procedure codes billed by Medicaid providers in Alabama, ranked by total spending.

#CodeDescriptionTotal Paid
1 T2016 Habilitation, residential, waiver; per diem $1.83B
2 T1015 Clinic visit/encounter, all-inclusive $700.30M
3 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) $627.87M
4 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $401.52M
5 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $369.06M
6 H0036 Community psychiatric supportive treatment, face-to-face, per 15 minutes $338.78M
7 81479 Unlisted molecular pathology procedure $267.89M
8 T2021 Day habilitation, waiver; per 15 minutes $211.68M
9 99284 Emergency department visit for the evaluation and management, high severity $192.22M
10 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $176.14M
11 G9008 Coordinated care fee, physician coordinated care oversight services $148.78M
12 T2023 Targeted case management; per month $142.07M
13 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $141.03M
14 90837 Psychotherapy, 53 minutes with patient $137.19M
15 T2046 Hospice long term care, room and board only; per diem $116.91M
16 87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets $114.89M
17 99283 Emergency department visit for the evaluation and management, moderate severity $109.05M
18 S5130 Homemaker service, nos; per 15 minutes $86.75M
19 A0436 Rotary wing air mileage, per statute mile $84.40M
20 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $73.62M
21 87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism $68.85M
22 90791 Psychiatric diagnostic evaluation $67.58M
23 99215 Prolong outpt/office vis $65.94M
24 S5170 Home delivered meals, including preparation; per meal $65.37M
25 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $64.77M
26 59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care $59.87M
27 97530 Therapeutic activities, direct patient contact, each 15 minutes $58.34M
28 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 $58.09M
29 99472 Subsequent inpatient pediatric critical care, per day, 2-5 years $57.79M
30 D1120 Prophylaxis - child $54.34M
31 H2012 Behavioral health day treatment, per hour $53.53M
32 A0425 Ground mileage, per statute mile $51.61M
33 D0120 Periodic oral evaluation - established patient $47.88M
34 H2017 Psychosocial rehabilitation services, per 15 minutes $47.10M
35 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $44.19M
36 90999 Unlisted dialysis procedure, inpatient or outpatient $43.81M
37 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $43.11M
38 99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger $42.08M
39 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $40.58M
40 H2027 Psychoeducational service, per 15 minutes $38.81M
41 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $38.72M
42 H2021 Community-based wrap-around services, per 15 minutes $38.58M
43 99232 Subsequent hospital care, per day, moderate complexity $38.25M
44 90832 Psychotherapy, 30 minutes with patient $37.49M
45 G0463 Hospital outpatient clinic visit for assessment and management of a patient $37.20M
46 H0004 Behavioral health counseling and therapy, per 15 minutes $37.03M
47 H0040 Assertive community treatment program, per diem $36.97M
48 99233 Prolong inpt eval add15 m $32.58M
49 D1208 Topical application of fluoride, excluding varnish $32.14M
50 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $31.38M
51 T1016 Case management, each 15 minutes $29.77M
52 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $28.96M
53 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $28.07M
54 87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms $27.93M
55 D2930 Prefabricated stainless steel crown - primary tooth $27.60M
56 D1110 Prophylaxis - adult $26.20M
57 87804 Infectious agent antigen detection by immunoassay; Influenza, each type $26.16M
58 90847 Family psychotherapy with the patient present, 50 minutes $24.86M
59 D1999 $24.36M
60 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $24.24M
61 59510 $24.13M
62 85025 Blood count; complete (CBC), automated, and automated differential WBC count $24.11M
63 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $23.95M
64 D0330 Panoramic radiographic image $23.74M
65 99479 Subsequent intensive care, per day, very low birth weight infant $23.31M
66 99244 Office or other outpatient consultation, moderate to high complexity $23.28M
67 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $23.05M
68 D2391 Resin-based composite - one surface, posterior, primary or permanent $22.68M
69 A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips $22.50M
70 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $22.44M
71 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $21.87M
72 H2022 Community-based wrap-around services, per diem $21.48M
73 80053 Comprehensive metabolic panel $21.28M
74 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $21.00M
75 D0272 Bitewings - two radiographic images $19.95M
76 87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A $19.89M
77 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) $19.87M
78 D7240 Removal of impacted tooth - completely bony $19.52M
79 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $19.51M
80 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $19.39M
81 D1354 $18.53M
82 90834 Psychotherapy, 45 minutes with patient $18.44M
83 H0035 Mental health partial hospitalization, treatment, less than 24 hours $18.38M
84 S9124 Nursing care, in the home; by licensed practical nurse, per hour $18.26M
85 H0032 Mental health service plan development by non-physician $18.24M
86 T2028 Specialized supply, not otherwise specified, waiver $17.96M
87 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $17.83M
88 T2002 Non-emergency transportation; per diem $17.76M
89 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $17.72M
90 87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe $17.49M
91 G9002 Coordinated care fee, maintenance rate $17.46M
92 80050 General health panel $17.17M
93 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $17.05M
94 S5150 Unskilled respite care, not hospice; per 15 minutes $17.03M
95 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $17.00M
96 D1206 Topical application of fluoride varnish $16.46M
97 81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants $16.39M
98 87581 $16.37M
99 84443 Thyroid stimulating hormone (TSH) $16.33M
100 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) $16.13M
101 87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets $16.12M
102 99309 Subsequent nursing facility care, per day, low to moderate complexity $15.87M
103 87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe $15.69M
104 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $15.25M
105 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $14.90M
106 88305 Level IV - Surgical pathology, gross and microscopic examination $14.74M
107 D7140 Extraction, erupted tooth or exposed root $14.33M
108 99282 Emergency department visit for the evaluation and management, low to moderate severity $14.20M
109 87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies $14.09M
110 80061 Lipid panel $13.69M
111 H0046 Mental health services, not otherwise specified $13.67M
112 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $13.41M
113 D9430 $13.35M
114 90460 Immunization administration through 18 years of age via any route, first or only component $13.31M
115 H0033 Oral medication administration, direct observation $13.15M
116 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $12.57M
117 S5135 Companion care, adult (e.g., iadl/adl); per 15 minutes $12.53M
118 92340 Fitting of spectacles, except for aphakia; monofocal $12.48M
119 A0435 Fixed wing air mileage, per statute mile $12.40M
120 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 $12.39M
121 H0034 Medication training and support, per 15 minutes $12.34M
122 99238 Hospital discharge day management, 30 minutes or less $12.28M
123 90670 $12.17M
124 90853 Group psychotherapy (other than of a multiple-family group) $11.75M
125 81420 Fetal chromosomal aneuploidy genomic sequence analysis panel $11.71M
126 83498 $11.49M
127 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $11.27M
128 87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) $11.22M
129 D1351 Sealant - per tooth $11.21M
130 99223 Prolong inpt eval add15 m $10.93M
131 87486 $10.39M
132 87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) $10.30M
133 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $10.27M
134 70450 Computed tomography, head or brain; without contrast material $10.00M
135 93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study $9.73M
136 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 $8.90M
137 D0274 Bitewings - four radiographic images $8.80M
138 82775 $8.70M
139 D9222 $8.63M
140 87507 $8.63M
141 87634 $8.60M
142 88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer $8.57M
143 99468 $8.51M
144 T1005 Respite care services, up to 15 minutes $8.49M
145 T1017 Targeted case management, each 15 minutes $8.48M
146 99460 $8.45M
147 S9083 Global fee urgent care centers $8.42M
148 D0150 Comprehensive oral evaluation - new or established patient $8.24M
149 V2020 Frames, purchases $8.13M
150 D7230 $7.90M
151 96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular $7.88M
152 99480 Subsequent intensive care, per day, low birth weight infant $7.71M
153 92015 Determination of refractive state $7.65M
154 87631 $7.63M
155 71045 Radiologic examination, chest; single view $7.61M
156 83036 Hemoglobin; glycosylated (A1C) $7.59M
157 00170 Anesthesia for intraoral procedures, including biopsy $7.41M
158 S9110 Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month $7.37M
159 80081 $7.27M
160 D2393 Resin-based composite - three surfaces, posterior, primary or permanent $7.25M
161 A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply $7.15M
162 87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B $7.08M
163 J2323 Injection, natalizumab, 1 mg $7.07M
164 01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery $6.97M
165 82139 $6.97M
166 82017 $6.97M
167 82261 $6.97M
168 82379 $6.97M
169 H2011 Crisis intervention service, per 15 minutes $6.92M
170 87481 $6.82M
171 74177 Computed tomography, abdomen and pelvis; with contrast material $6.78M
172 T1040 Medicaid certified community behavioral health clinic services, per diem $6.77M
173 99243 $6.76M
174 H2019 Therapeutic behavioral services, per 15 minutes $6.75M
175 90686 $6.66M
176 D0140 Limited oral evaluation - problem focused $6.63M
177 V2784 Lens, polycarbonate or equal, any index, per lens $6.56M
178 87428 $6.53M
179 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $6.52M
180 A9274 External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories $6.34M
181 65778 $6.28M
182 T2015 Habilitation, prevocational, waiver; per hour $6.14M
183 T2019 Habilitation, supported employment, waiver; per 15 minutes $6.10M
184 71046 Radiologic examination, chest; 2 views $6.07M
185 99205 Prolong outpt/office vis $6.05M
186 V2750 Anti-reflective coating, per lens $5.98M
187 J0791 Injection, crizanlizumab-tmca, 5 mg $5.98M
188 Q4081 Injection, epoetin alfa, 100 units (for esrd on dialysis) $5.94M
189 81329 $5.87M
190 B9002 Enteral nutrition infusion pump, any type $5.78M
191 90680 $5.77M
192 87086 Culture, bacterial; quantitative colony count, urine $5.68M
193 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $5.57M
194 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $5.53M
195 90461 $5.51M
196 83520 $5.40M
197 42820 Tonsillectomy and adenoidectomy; younger than age 12 $5.32M
198 A4353 Intermittent urinary catheter, with insertion supplies $5.27M
199 99245 $5.26M
200 99308 Subsequent nursing facility care, per day, straightforward $5.18M