Medicaid Provider Spending

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

Billing Codes in Colorado

All 3,277 procedure codes billed by Medicaid providers in Colorado, ranked by total spending.

#CodeDescriptionTotal Paid
1 T2016 Habilitation, residential, waiver; per diem $2.39B
2 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) $1.66B
3 A0100 Non-emergency transportation; taxi $1.32B
4 H0038 Self-help/peer services, per 15 minutes $1.32B
5 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $888.32M
6 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $710.88M
7 A0130 Non-emergency transportation: wheelchair van $664.55M
8 T2021 Day habilitation, waiver; per 15 minutes $658.48M
9 S5130 Homemaker service, nos; per 15 minutes $406.21M
10 90837 Psychotherapy, 53 minutes with patient $382.89M
11 A0120 Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems $370.36M
12 D0999 Unspecified diagnostic procedure, by report $295.74M
13 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $292.44M
14 99283 Emergency department visit for the evaluation and management, moderate severity $276.65M
15 T2031 Assisted living; waiver, per diem $262.65M
16 99284 Emergency department visit for the evaluation and management, high severity $255.33M
17 T2003 Non-emergency transportation; encounter/trip $249.50M
18 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $232.79M
19 S9122 Home health aide or certified nurse assistant, providing care in the home; per hour $229.25M
20 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $211.37M
21 A0090 Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest $206.54M
22 S5105 Day care services, center-based; services not included in program fee, per diem $186.04M
23 A0425 Ground mileage, per statute mile $177.66M
24 T1017 Targeted case management, each 15 minutes $152.75M
25 97530 Therapeutic activities, direct patient contact, each 15 minutes $152.69M
26 T2019 Habilitation, supported employment, waiver; per 15 minutes $150.15M
27 T2023 Targeted case management; per month $149.08M
28 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $147.01M
29 T1000 Private duty / independent nursing service(s) - licensed, up to 15 minutes $126.64M
30 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $119.72M
31 H2021 Community-based wrap-around services, per 15 minutes $110.69M
32 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $102.10M
33 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $99.29M
34 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $97.81M
35 L8619 Cochlear implant, external speech processor and controller, integrated system, replacement $96.09M
36 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $95.83M
37 V2410 Variable asphericity lens, single vision, full field, glass or plastic, per lens $88.26M
38 S5150 Unskilled respite care, not hospice; per 15 minutes $88.24M
39 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $82.12M
40 H0004 Behavioral health counseling and therapy, per 15 minutes $81.10M
41 99215 Prolong outpt/office vis $80.39M
42 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $77.48M
43 T2030 Assisted living, waiver; per month $72.06M
44 97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes $71.76M
45 90834 Psychotherapy, 45 minutes with patient $70.57M
46 D0120 Periodic oral evaluation - established patient $67.75M
47 D1110 Prophylaxis - adult $67.12M
48 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $65.00M
49 96361 Intravenous infusion, hydration; each additional hour $64.36M
50 H2014 Skills training and development, per 15 minutes $63.17M
51 H2036 Alcohol and/or other drug treatment program, per diem $62.99M
52 H2019 Therapeutic behavioral services, per 15 minutes $60.99M
53 T2033 Residential care, not otherwise specified (nos), waiver; per diem $60.38M
54 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $58.59M
55 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $57.63M
56 B4160 Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 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 $57.20M
57 D1120 Prophylaxis - child $56.58M
58 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 $56.17M
59 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $54.47M
60 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $50.47M
61 B4161 Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit $49.09M
62 D1206 Topical application of fluoride varnish $49.04M
63 D2740 Crown - porcelain/ceramic $47.52M
64 H0005 Alcohol and/or drug services; group counseling by a clinician $47.13M
65 G0156 Services of home health/hospice aide in home health or hospice settings, each 15 minutes $47.00M
66 S9128 Speech therapy, in the home, per diem $44.37M
67 D2391 Resin-based composite - one surface, posterior, primary or permanent $44.27M
68 99233 Prolong inpt eval add15 m $43.03M
69 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $42.04M
70 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $42.04M
71 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $41.42M
72 H0010 Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) $41.42M
73 90832 Psychotherapy, 30 minutes with patient $39.62M
74 V2020 Frames, purchases $39.51M
75 D7140 Extraction, erupted tooth or exposed root $37.99M
76 90999 Unlisted dialysis procedure, inpatient or outpatient $37.38M
77 A0110 Non-emergency transportation and bus, intra or inter state carrier $36.80M
78 D2930 Prefabricated stainless steel crown - primary tooth $36.59M
79 E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) $34.95M
80 99232 Subsequent hospital care, per day, moderate complexity $33.72M
81 90460 Immunization administration through 18 years of age via any route, first or only component $32.81M
82 A4554 Disposable underpads, all sizes $32.71M
83 T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each $32.61M
84 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $32.45M
85 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $32.16M
86 G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes $31.81M
87 D0150 Comprehensive oral evaluation - new or established patient $31.61M
88 74177 Computed tomography, abdomen and pelvis; with contrast material $31.14M
89 T2024 Service assessment/plan of care development, waiver $30.95M
90 99282 Emergency department visit for the evaluation and management, low to moderate severity $30.58M
91 H0023 Behavioral health outreach service (planned approach to reach a targeted population) $30.34M
92 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $29.45M
93 E1399 Durable medical equipment, miscellaneous $29.34M
94 90791 Psychiatric diagnostic evaluation $28.60M
95 D7240 Removal of impacted tooth - completely bony $28.59M
96 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $27.51M
97 V2784 Lens, polycarbonate or equal, any index, per lens $27.47M
98 H0017 Behavioral health; residential (hospital residential treatment program), without room and board, per diem $26.81M
99 D2393 Resin-based composite - three surfaces, posterior, primary or permanent $26.35M
100 D0274 Bitewings - four radiographic images $25.98M
101 T2005 Non-emergency transportation; stretcher van $25.64M
102 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $25.26M
103 L8692 Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment $25.20M
104 T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each $25.11M
105 88305 Level IV - Surgical pathology, gross and microscopic examination $25.00M
106 41899 Unlisted procedure, dentoalveolar structures $24.08M
107 V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens $24.06M
108 H0046 Mental health services, not otherwise specified $23.59M
109 A4556 Electrodes, (e.g., apnea monitor), per pair $23.43M
110 D0330 Panoramic radiographic image $23.41M
111 80053 Comprehensive metabolic panel $23.10M
112 H2011 Crisis intervention service, per 15 minutes $22.66M
113 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 $22.61M
114 J0585 Injection, onabotulinumtoxina, 1 unit $22.56M
115 A9274 External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories $22.42M
116 A4353 Intermittent urinary catheter, with insertion supplies $22.39M
117 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $22.26M
118 D0220 Intraoral - periapical first radiographic image $22.05M
119 H0025 Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) $21.89M
120 S0215 Non-emergency transportation; mileage, per mile $21.48M
121 A0180 Non-emergency transportation: ancillary: lodging-recipient $21.37M
122 D0230 Intraoral - periapical each additional radiographic image $21.35M
123 96110 Developmental screening, with scoring and documentation, per standardized instrument $21.30M
124 H0002 Behavioral health screening to determine eligibility for admission to treatment program $21.08M
125 D8660 $20.97M
126 G0176 Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) $20.95M
127 T4535 Disposable liner/shield/guard/pad/undergarment, for incontinence, each $20.95M
128 D1351 Sealant - per tooth $20.53M
129 S9129 Occupational therapy, in the home, per diem $20.16M
130 D2150 Silver amalgam - two surfaces, primary or permanent $20.15M
131 70450 Computed tomography, head or brain; without contrast material $19.76M
132 S5161 Emergency response system; service fee, per month (excludes installation and testing) $19.49M
133 92340 Fitting of spectacles, except for aphakia; monofocal $19.40M
134 B4149 Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit $19.32M
135 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $19.20M
136 D0350 $18.76M
137 D0140 Limited oral evaluation - problem focused $17.64M
138 A4927 Gloves, non-sterile, per 100 $17.61M
139 T4534 Youth sized disposable incontinence product, protective underwear/pull-on, each $17.21M
140 S5151 Unskilled respite care, not hospice; per diem $16.77M
141 D0210 Intraoral - complete series of radiographic images $16.67M
142 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $16.60M
143 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 $16.49M
144 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $16.31M
145 D0272 Bitewings - two radiographic images $16.07M
146 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $15.93M
147 B4155 Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit $15.69M
148 H0031 Mental health assessment, by non-physician $15.62M
149 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) $15.38M
150 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 $15.34M
151 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $15.31M
152 A6250 Skin sealants, protectants, moisturizers, ointments, any type, any size $15.29M
153 B4088 Gastrostomy/jejunostomy tube, low-profile, any material, any type, each $15.24M
154 J2315 Injection, naltrexone, depot form, 1 mg $14.82M
155 A0436 Rotary wing air mileage, per statute mile $14.65M
156 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $14.05M
157 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $13.86M
158 D8090 $13.77M
159 99223 Prolong inpt eval add15 m $13.70M
160 B9998 Noc for enteral supplies $13.66M
161 87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism $13.36M
162 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 $13.28M
163 A4239 Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service $13.11M
164 E2402 Negative pressure wound therapy electrical pump, stationary or portable $13.07M
165 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report $13.04M
166 S9480 Intensive outpatient psychiatric services, per diem $12.89M
167 K0553 Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service $12.78M
168 E0431 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing $12.73M
169 80050 General health panel $12.42M
170 97124 $12.10M
171 T4528 Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each $12.05M
172 H0011 Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) $12.02M
173 A0426 Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) $11.87M
174 V2750 Anti-reflective coating, per lens $11.87M
175 T2004 Non-emergency transport; commercial carrier, multi-pass $11.84M
176 E0601 Continuous positive airway pressure (cpap) device $11.81M
177 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 $11.74M
178 D9410 $11.64M
179 H0035 Mental health partial hospitalization, treatment, less than 24 hours $11.62M
180 V2025 Deluxe frame $11.57M
181 L3000 Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each $11.49M
182 S5165 Home modifications; per service $11.46M
183 92609 $11.33M
184 H2033 Multisystemic therapy for juveniles, per 15 minutes $11.33M
185 90853 Group psychotherapy (other than of a multiple-family group) $11.18M
186 K0108 Wheelchair component or accessory, not otherwise specified $11.16M
187 71045 Radiologic examination, chest; single view $10.95M
188 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $10.82M
189 H0032 Mental health service plan development by non-physician $10.80M
190 D9222 $10.72M
191 90847 Family psychotherapy with the patient present, 50 minutes $10.41M
192 99309 Subsequent nursing facility care, per day, low to moderate complexity $10.25M
193 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $10.06M
194 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $10.05M
195 36475 $9.93M
196 H0039 Assertive community treatment, face-to-face, per 15 minutes $9.90M
197 90792 Psychiatric diagnostic evaluation with medical services $9.89M
198 T2015 Habilitation, prevocational, waiver; per hour $9.84M
199 97533 $9.82M
200 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 $9.80M