Medicaid Provider Spending

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

Billing Codes in Florida

All 4,739 procedure codes billed by Medicaid providers in Florida, ranked by total spending.

#CodeDescriptionTotal Paid
1 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) $1.91B
2 S9124 Nursing care, in the home; by licensed practical nurse, per hour $1.52B
3 S5130 Homemaker service, nos; per 15 minutes $1.45B
4 H2017 Psychosocial rehabilitation services, per 15 minutes $1.28B
5 H2019 Therapeutic behavioral services, per 15 minutes $1.04B
6 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $1.00B
7 90999 Unlisted dialysis procedure, inpatient or outpatient $939.57M
8 T2030 Assisted living, waiver; per month $889.50M
9 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $886.47M
10 T1017 Targeted case management, each 15 minutes $849.97M
11 99283 Emergency department visit for the evaluation and management, moderate severity $838.68M
12 99284 Emergency department visit for the evaluation and management, high severity $780.03M
13 S9122 Home health aide or certified nurse assistant, providing care in the home; per hour $771.97M
14 97530 Therapeutic activities, direct patient contact, each 15 minutes $730.83M
15 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $729.14M
16 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) $666.36M
17 T1025 Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem $549.13M
18 T1004 Services of a qualified nursing aide, up to 15 minutes $489.96M
19 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $489.17M
20 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $434.39M
21 H2014 Skills training and development, per 15 minutes $404.39M
22 Q4081 Injection, epoetin alfa, 100 units (for esrd on dialysis) $372.91M
23 T2023 Targeted case management; per month $331.69M
24 S5135 Companion care, adult (e.g., iadl/adl); per 15 minutes $321.97M
25 S5102 Day care services, adult; per diem $317.10M
26 A4657 Syringe, with or without needle, each $304.56M
27 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $240.42M
28 T2046 Hospice long term care, room and board only; per diem $239.11M
29 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $238.32M
30 J1270 Injection, doxercalciferol, 1 mcg $227.35M
31 T1015 Clinic visit/encounter, all-inclusive $213.34M
32 A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply $202.63M
33 H1000 Prenatal care, at-risk assessment $201.44M
34 S5170 Home delivered meals, including preparation; per meal $196.88M
35 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $192.26M
36 Q5003 Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf) $159.12M
37 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $158.96M
38 99232 Subsequent hospital care, per day, moderate complexity $146.93M
39 99282 Emergency department visit for the evaluation and management, low to moderate severity $145.86M
40 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $131.77M
41 99233 Prolong inpt eval add15 m $130.78M
42 T2016 Habilitation, residential, waiver; per diem $128.17M
43 80053 Comprehensive metabolic panel $124.13M
44 S5150 Unskilled respite care, not hospice; per 15 minutes $123.95M
45 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $115.78M
46 74177 Computed tomography, abdomen and pelvis; with contrast material $109.43M
47 J1756 Injection, iron sucrose, 1 mg $108.67M
48 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $107.97M
49 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $107.19M
50 H0032 Mental health service plan development by non-physician $105.71M
51 H0031 Mental health assessment, by non-physician $103.31M
52 S5100 Day care services, adult; per 15 minutes $103.30M
53 A0100 Non-emergency transportation; taxi $102.19M
54 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $99.68M
55 T1021 Home health aide or certified nurse assistant, per visit $98.45M
56 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $94.96M
57 97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes $92.63M
58 70450 Computed tomography, head or brain; without contrast material $91.53M
59 D2930 Prefabricated stainless steel crown - primary tooth $90.63M
60 99223 Prolong inpt eval add15 m $85.38M
61 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $83.10M
62 90460 Immunization administration through 18 years of age via any route, first or only component $80.80M
63 T1020 Personal care services, per diem, 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) $76.16M
64 85025 Blood count; complete (CBC), automated, and automated differential WBC count $76.07M
65 99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger $75.71M
66 99215 Prolong outpt/office vis $74.82M
67 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 $74.48M
68 36415 Collection of venous blood by venipuncture $72.14M
69 D1120 Prophylaxis - child $69.93M
70 D0120 Periodic oral evaluation - established patient $68.96M
71 S9083 Global fee urgent care centers $68.75M
72 96361 Intravenous infusion, hydration; each additional hour $68.19M
73 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $67.17M
74 H2000 Comprehensive multidisciplinary evaluation $66.36M
75 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $65.63M
76 G9012 Other specified case management service not elsewhere classified $65.48M
77 85018 $63.37M
78 D1110 Prophylaxis - adult $63.27M
79 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $60.63M
80 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $59.29M
81 97535 Self-care/home management training, each 15 minutes $58.62M
82 74176 Computed tomography, abdomen and pelvis; without contrast material $58.08M
83 84520 $56.56M
84 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 $54.94M
85 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $54.84M
86 S5145 Foster care, therapeutic, child; per diem $52.32M
87 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $51.52M
88 83540 $51.20M
89 83970 $51.04M
90 88305 Level IV - Surgical pathology, gross and microscopic examination $49.59M
91 T1027 Family training and counseling for child development, per 15 minutes $48.77M
92 E0784 External ambulatory infusion pump, insulin $48.59M
93 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $47.72M
94 A0425 Ground mileage, per statute mile $47.61M
95 99479 Subsequent intensive care, per day, very low birth weight infant $47.29M
96 A0130 Non-emergency transportation: wheelchair van $46.83M
97 D0150 Comprehensive oral evaluation - new or established patient $46.63M
98 A9277 Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system $45.75M
99 90837 Psychotherapy, 53 minutes with patient $44.27M
100 G0378 Hospital observation service, per hour $44.18M
101 99472 Subsequent inpatient pediatric critical care, per day, 2-5 years $43.75M
102 83550 $43.14M
103 D7140 Extraction, erupted tooth or exposed root $42.11M
104 J0887 Injection, epoetin beta, 1 microgram, (for esrd on dialysis) $41.24M
105 J1644 Injection, heparin sodium, per 1000 units $40.74M
106 82728 $40.51M
107 G0463 Hospital outpatient clinic visit for assessment and management of a patient $40.14M
108 H0040 Assertive community treatment program, per diem $40.12M
109 E1399 Durable medical equipment, miscellaneous $39.63M
110 T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each $38.71M
111 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $38.69M
112 D0330 Panoramic radiographic image $38.12M
113 84100 $37.30M
114 Q0508 Miscellaneous supply or accessory for use with an implanted ventricular assist device $37.20M
115 99309 Subsequent nursing facility care, per day, low to moderate complexity $36.76M
116 J2501 Injection, paricalcitol, 1 mcg $36.43M
117 T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each $36.06M
118 80048 Basic metabolic panel (calcium, ionized) $35.05M
119 99222 Initial hospital care, per day, moderate complexity $35.01M
120 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour $34.81M
121 92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder $34.72M
122 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $34.51M
123 A4239 Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service $34.42M
124 A4554 Disposable underpads, all sizes $34.36M
125 T2003 Non-emergency transportation; encounter/trip $34.20M
126 59410 $33.89M
127 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $33.87M
128 81479 Unlisted molecular pathology procedure $33.84M
129 82310 $33.74M
130 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $33.32M
131 A4230 Infusion set for external insulin pump, non needle cannula type $33.04M
132 99480 Subsequent intensive care, per day, low birth weight infant $33.01M
133 97116 $32.66M
134 99308 Subsequent nursing facility care, per day, straightforward $31.53M
135 99281 Emergency department visit for the evaluation and management, self-limited or minor $31.21M
136 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $31.04M
137 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $30.69M
138 A4353 Intermittent urinary catheter, with insertion supplies $29.79M
139 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 $29.70M
140 V2020 Frames, purchases $29.39M
141 Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml $28.93M
142 93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study $28.63M
143 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $27.83M
144 96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour $27.76M
145 87804 Infectious agent antigen detection by immunoassay; Influenza, each type $27.76M
146 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 $27.28M
147 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $27.20M
148 97156 $27.02M
149 Q5001 Hospice or home health care provided in patient's home/residence $27.01M
150 E0570 Nebulizer, with compressor $26.98M
151 0202U Oncology (prostate), multianalyte, gene expression profiling $26.77M
152 71045 Radiologic examination, chest; single view $26.73M
153 99244 Office or other outpatient consultation, moderate to high complexity $26.28M
154 71046 Radiologic examination, chest; 2 views $25.23M
155 81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants $25.12M
156 H0019 Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem $24.72M
157 D9420 $24.65M
158 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $24.48M
159 99238 Hospital discharge day management, 30 minutes or less $23.61M
160 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $23.37M
161 84155 $23.30M
162 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $23.16M
163 96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance $23.14M
164 E0601 Continuous positive airway pressure (cpap) device $22.93M
165 96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular $22.85M
166 H2020 Therapeutic behavioral services, per diem $22.60M
167 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $22.55M
168 42820 Tonsillectomy and adenoidectomy; younger than age 12 $22.36M
169 82040 $22.33M
170 95810 Polysomnography; sleep staging with 4 or more additional parameters $22.26M
171 T4528 Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each $22.13M
172 S5161 Emergency response system; service fee, per month (excludes installation and testing) $22.08M
173 80061 Lipid panel $22.05M
174 A9274 External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories $22.02M
175 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials $21.90M
176 D2391 Resin-based composite - one surface, posterior, primary or permanent $21.68M
177 H2012 Behavioral health day treatment, per hour $21.66M
178 71275 Computed tomographic angiography, chest, with contrast material $21.60M
179 T2042 Hospice routine home care; per diem $21.13M
180 81420 Fetal chromosomal aneuploidy genomic sequence analysis panel $20.87M
181 V2100 Sphere, single vision, plano to plus or minus 4.00, per lens $20.79M
182 85041 $20.75M
183 K0553 Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service $20.65M
184 85048 $20.57M
185 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $20.56M
186 99460 $20.51M
187 82565 $20.28M
188 S5199 Personal care item, nos, each $20.27M
189 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $20.15M
190 76819 Fetal biophysical profile; without non-stress testing $20.07M
191 84443 Thyroid stimulating hormone (TSH) $20.05M
192 S5125 Attendant care services; per 15 minutes $19.90M
193 92523 $19.69M
194 T2032 Residential care, not otherwise specified (nos), waiver; per month $19.11M
195 99239 Hospital discharge day management, more than 30 minutes $18.86M
196 S9342 Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem $18.68M
197 00170 Anesthesia for intraoral procedures, including biopsy $18.52M
198 01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery $18.19M
199 87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets $17.90M
200 D1351 Sealant - per tooth $17.34M