Medicaid Provider Spending

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

Billing Codes in Georgia

All 2,961 procedure codes billed by Medicaid providers in Georgia, ranked by total spending.

#CodeDescriptionTotal Paid
1 S5125 Attendant care services; per 15 minutes $477.73M
2 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $330.59M
3 T2033 Residential care, not otherwise specified (nos), waiver; per diem $304.11M
4 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $259.38M
5 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) $235.65M
6 T2025 Waiver services; not otherwise specified (nos) $224.62M
7 99284 Emergency department visit for the evaluation and management, high severity $216.51M
8 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $201.84M
9 99283 Emergency department visit for the evaluation and management, moderate severity $184.68M
10 T2017 Habilitation, residential, waiver; 15 minutes $165.48M
11 90837 Psychotherapy, 53 minutes with patient $131.10M
12 T2022 Case management, per month $85.04M
13 S9351 Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem $78.79M
14 T1021 Home health aide or certified nurse assistant, per visit $76.98M
15 T1005 Respite care services, up to 15 minutes $60.86M
16 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $54.68M
17 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $42.81M
18 90460 Immunization administration through 18 years of age via any route, first or only component $42.48M
19 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $40.81M
20 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 $38.34M
21 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $37.21M
22 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $35.94M
23 J1726 Injection, hydroxyprogesterone caproate, (makena), 10 mg $32.75M
24 97530 Therapeutic activities, direct patient contact, each 15 minutes $30.74M
25 74177 Computed tomography, abdomen and pelvis; with contrast material $29.61M
26 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $29.51M
27 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $29.15M
28 D1120 Prophylaxis - child $25.13M
29 G0378 Hospital observation service, per hour $23.12M
30 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $22.69M
31 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $22.09M
32 S5102 Day care services, adult; per diem $21.98M
33 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 $21.97M
34 D2930 Prefabricated stainless steel crown - primary tooth $21.81M
35 70551 Magnetic resonance imaging, brain; without contrast material $21.71M
36 T1003 Lpn/lvn services, up to 15 minutes $21.69M
37 70450 Computed tomography, head or brain; without contrast material $21.56M
38 H2015 Comprehensive community support services, per 15 minutes $20.72M
39 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $20.58M
40 99282 Emergency department visit for the evaluation and management, low to moderate severity $20.49M
41 90834 Psychotherapy, 45 minutes with patient $20.38M
42 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $20.37M
43 70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences $19.65M
44 S9124 Nursing care, in the home; by licensed practical nurse, per hour $19.24M
45 H2017 Psychosocial rehabilitation services, per 15 minutes $18.83M
46 99233 Prolong inpt eval add15 m $18.71M
47 D0120 Periodic oral evaluation - established patient $17.77M
48 H0031 Mental health assessment, by non-physician $17.76M
49 99232 Subsequent hospital care, per day, moderate complexity $17.31M
50 A0425 Ground mileage, per statute mile $17.20M
51 A0120 Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems $16.95M
52 S9560 Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem $16.81M
53 95810 Polysomnography; sleep staging with 4 or more additional parameters $16.35M
54 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 $15.91M
55 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $15.83M
56 80053 Comprehensive metabolic panel $15.51M
57 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $15.26M
58 88305 Level IV - Surgical pathology, gross and microscopic examination $14.71M
59 71046 Radiologic examination, chest; 2 views $14.55M
60 T2028 Specialized supply, not otherwise specified, waiver $14.52M
61 T1015 Clinic visit/encounter, all-inclusive $14.27M
62 H0038 Self-help/peer services, per 15 minutes $13.94M
63 H2019 Therapeutic behavioral services, per 15 minutes $13.82M
64 G0482 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; 15-21 drug class(es), including metabolite(s) if performed $13.66M
65 96361 Intravenous infusion, hydration; each additional hour $13.51M
66 95782 $13.12M
67 T1016 Case management, each 15 minutes $12.93M
68 99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger $12.73M
69 D1351 Sealant - per tooth $12.57M
70 90999 Unlisted dialysis procedure, inpatient or outpatient $12.52M
71 42820 Tonsillectomy and adenoidectomy; younger than age 12 $12.50M
72 76819 Fetal biophysical profile; without non-stress testing $12.29M
73 H0039 Assertive community treatment, face-to-face, per 15 minutes $12.18M
74 85025 Blood count; complete (CBC), automated, and automated differential WBC count $11.74M
75 D2391 Resin-based composite - one surface, posterior, primary or permanent $11.72M
76 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $11.48M
77 90853 Group psychotherapy (other than of a multiple-family group) $11.45M
78 99215 Prolong outpt/office vis $11.16M
79 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $10.95M
80 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $10.95M
81 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $10.65M
82 D0274 Bitewings - four radiographic images $10.61M
83 93325 $10.46M
84 D1208 Topical application of fluoride, excluding varnish $10.37M
85 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $10.34M
86 44970 $10.11M
87 J1599 Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg $9.95M
88 D0150 Comprehensive oral evaluation - new or established patient $9.82M
89 A0160 Non-emergency transportation: per mile - case worker or social worker $9.78M
90 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $9.66M
91 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour $9.44M
92 D0272 Bitewings - two radiographic images $9.40M
93 90792 Psychiatric diagnostic evaluation with medical services $9.35M
94 A0090 Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest $9.30M
95 99601 $9.30M
96 D7240 Removal of impacted tooth - completely bony $9.21M
97 71045 Radiologic examination, chest; single view $9.17M
98 0202U Oncology (prostate), multianalyte, gene expression profiling $9.07M
99 87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B $8.97M
100 S5130 Homemaker service, nos; per 15 minutes $8.95M
101 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $8.89M
102 A4353 Intermittent urinary catheter, with insertion supplies $8.83M
103 G0481 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; 8-14 drug class(es), including metabolite(s) if performed $8.80M
104 87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) $8.62M
105 80061 Lipid panel $8.61M
106 D1110 Prophylaxis - adult $8.61M
107 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $8.55M
108 96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance $8.54M
109 99223 Prolong inpt eval add15 m $8.50M
110 81420 Fetal chromosomal aneuploidy genomic sequence analysis panel $8.29M
111 90832 Psychotherapy, 30 minutes with patient $8.26M
112 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $8.16M
113 A9274 External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories $8.11M
114 74176 Computed tomography, abdomen and pelvis; without contrast material $8.03M
115 87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A $7.99M
116 96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular $7.96M
117 84443 Thyroid stimulating hormone (TSH) $7.72M
118 J1569 Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg $7.55M
119 87804 Infectious agent antigen detection by immunoassay; Influenza, each type $7.53M
120 97150 Therapeutic procedure(s), group (2 or more individuals) $7.52M
121 A0100 Non-emergency transportation; taxi $7.52M
122 90847 Family psychotherapy with the patient present, 50 minutes $7.50M
123 D9420 $7.48M
124 80050 General health panel $7.42M
125 99244 Office or other outpatient consultation, moderate to high complexity $7.32M
126 D0220 Intraoral - periapical first radiographic image $7.23M
127 76770 $7.11M
128 81220 CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants $7.07M
129 96375 Therapeutic injection; each additional sequential IV push $7.06M
130 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $7.03M
131 93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study $7.00M
132 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 $6.71M
133 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $6.66M
134 S9211 Home management of gestational hypertension, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code) $6.65M
135 A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply $6.50M
136 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report $6.49M
137 87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms $6.38M
138 H0032 Mental health service plan development by non-physician $6.30M
139 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $6.23M
140 D7140 Extraction, erupted tooth or exposed root $6.16M
141 99051 $6.07M
142 J1745 Injection, infliximab, excludes biosimilar, 10 mg $6.07M
143 V2020 Frames, purchases $5.90M
144 70543 $5.88M
145 D1206 Topical application of fluoride varnish $5.88M
146 D0330 Panoramic radiographic image $5.81M
147 S5170 Home delivered meals, including preparation; per meal $5.73M
148 T2048 Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem $5.51M
149 P9016 Red blood cells, leukocytes reduced, each unit $5.51M
150 95812 $5.39M
151 D0230 Intraoral - periapical each additional radiographic image $5.31M
152 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $5.26M
153 74230 $5.17M
154 88312 $5.10M
155 87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets $5.07M
156 74183 $5.06M
157 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) $5.04M
158 96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour $5.04M
159 81408 $5.04M
160 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 $5.02M
161 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) $4.96M
162 73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material $4.94M
163 J3490 Unclassified drugs $4.90M
164 T1002 Rn services, up to 15 minutes $4.88M
165 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $4.87M
166 90791 Psychiatric diagnostic evaluation $4.84M
167 99479 Subsequent intensive care, per day, very low birth weight infant $4.79M
168 72197 $4.74M
169 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $4.73M
170 76705 Ultrasound, abdominal, real time with image documentation; limited $4.66M
171 83036 Hemoglobin; glycosylated (A1C) $4.66M
172 H2014 Skills training and development, per 15 minutes $4.66M
173 87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism $4.63M
174 99309 Subsequent nursing facility care, per day, low to moderate complexity $4.60M
175 87428 $4.58M
176 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $4.48M
177 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation $4.46M
178 59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care $4.45M
179 71260 Computed tomography, thorax, diagnostic; with contrast material $4.43M
180 76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal $4.40M
181 V2100 Sphere, single vision, plano to plus or minus 4.00, per lens $4.35M
182 93975 $4.34M
183 H2012 Behavioral health day treatment, per hour $4.30M
184 87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies $4.29M
185 92611 $4.24M
186 0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel $4.24M
187 H0044 Supported housing, per month $4.22M
188 76825 $4.18M
189 99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward $4.09M
190 76818 $4.08M
191 S9214 Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code) $4.05M
192 87799 $4.05M
193 T1001 Nursing assessment / evaluation $4.02M
194 H0004 Behavioral health counseling and therapy, per 15 minutes $4.00M
195 87086 Culture, bacterial; quantitative colony count, urine $3.97M
196 99472 Subsequent inpatient pediatric critical care, per day, 2-5 years $3.93M
197 J1729 Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg $3.92M
198 76700 Ultrasound, abdominal, real time with image documentation; complete $3.91M
199 94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction $3.84M
200 D2393 Resin-based composite - three surfaces, posterior, primary or permanent $3.84M