Medicaid Provider Spending

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

Billing Codes in Iowa

All 2,320 procedure codes billed by Medicaid providers in Iowa, ranked by total spending.

#CodeDescriptionTotal Paid
1 H2016 Comprehensive community support services, per diem $2.67B
2 S5136 Companion care, adult (e.g., iadl/adl); per diem $1.46B
3 T1015 Clinic visit/encounter, all-inclusive $931.97M
4 S5170 Home delivered meals, including preparation; per meal $882.53M
5 T2020 Day habilitation, waiver; per diem $307.98M
6 90834 Psychotherapy, 45 minutes with patient $231.87M
7 99284 Emergency department visit for the evaluation and management, high severity $222.93M
8 99490 Ccm add 20min $216.90M
9 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $201.92M
10 G0463 Hospital outpatient clinic visit for assessment and management of a patient $198.00M
11 H2015 Comprehensive community support services, per 15 minutes $177.01M
12 99283 Emergency department visit for the evaluation and management, moderate severity $167.00M
13 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $165.69M
14 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) $152.82M
15 A0999 Unlisted ambulance service $141.99M
16 H2019 Therapeutic behavioral services, per 15 minutes $137.13M
17 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $130.15M
18 H2025 Ongoing support to maintain employment, per 15 minutes $123.41M
19 D9999 Unspecified adjunctive procedure, by report $109.72M
20 90837 Psychotherapy, 53 minutes with patient $88.52M
21 96159 $72.17M
22 S5125 Attendant care services; per 15 minutes $70.71M
23 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 $69.78M
24 S5150 Unskilled respite care, not hospice; per 15 minutes $67.57M
25 E2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access $56.84M
26 98941 Chiropractic manipulative treatment; spinal, 3-4 regions $55.92M
27 H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem $55.80M
28 H0040 Assertive community treatment program, per diem $55.16M
29 D0999 Unspecified diagnostic procedure, by report $54.66M
30 W1760 $50.09M
31 96165 $41.76M
32 90791 Psychiatric diagnostic evaluation $40.53M
33 T2021 Day habilitation, waiver; per 15 minutes $39.85M
34 96152 $36.33M
35 96153 $35.70M
36 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $33.73M
37 T1017 Targeted case management, each 15 minutes $31.92M
38 S5126 Attendant care services; per diem $30.91M
39 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $29.89M
40 90853 Group psychotherapy (other than of a multiple-family group) $28.55M
41 D0120 Periodic oral evaluation - established patient $28.40M
42 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $28.20M
43 D1120 Prophylaxis - child $25.18M
44 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $24.29M
45 H2034 Alcohol and/or drug abuse halfway house services, per diem $23.31M
46 D1110 Prophylaxis - adult $23.31M
47 90832 Psychotherapy, 30 minutes with patient $22.60M
48 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) $21.65M
49 90792 Psychiatric diagnostic evaluation with medical services $21.30M
50 S5102 Day care services, adult; per diem $20.90M
51 D1206 Topical application of fluoride varnish $20.83M
52 H0037 Community psychiatric supportive treatment program, per diem $20.82M
53 T2031 Assisted living; waiver, per diem $20.36M
54 G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes $20.12M
55 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $19.91M
56 A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply $19.73M
57 T1005 Respite care services, up to 15 minutes $19.55M
58 99232 Subsequent hospital care, per day, moderate complexity $19.41M
59 H0033 Oral medication administration, direct observation $19.14M
60 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $19.06M
61 S0215 Non-emergency transportation; mileage, per mile $18.78M
62 90460 Immunization administration through 18 years of age via any route, first or only component $18.07M
63 90999 Unlisted dialysis procedure, inpatient or outpatient $17.81M
64 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $17.62M
65 T1024 Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter $17.19M
66 D2930 Prefabricated stainless steel crown - primary tooth $17.05M
67 G0156 Services of home health/hospice aide in home health or hospice settings, each 15 minutes $16.96M
68 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $16.85M
69 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $16.58M
70 D8080 Comprehensive orthodontic treatment of the adolescent dentition $15.80M
71 97530 Therapeutic activities, direct patient contact, each 15 minutes $15.77M
72 H2023 Supported employment, per 15 minutes $15.73M
73 S5130 Homemaker service, nos; per 15 minutes $15.69M
74 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $15.52M
75 H2017 Psychosocial rehabilitation services, per 15 minutes $15.37M
76 D7140 Extraction, erupted tooth or exposed root $15.05M
77 88305 Level IV - Surgical pathology, gross and microscopic examination $14.79M
78 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $13.94M
79 A0130 Non-emergency transportation: wheelchair van $13.92M
80 E0601 Continuous positive airway pressure (cpap) device $12.83M
81 W0560 $12.66M
82 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $12.62M
83 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $12.52M
84 A0110 Non-emergency transportation and bus, intra or inter state carrier $12.48M
85 T2015 Habilitation, prevocational, waiver; per hour $12.34M
86 99282 Emergency department visit for the evaluation and management, low to moderate severity $12.28M
87 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 $11.96M
88 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $11.61M
89 D1351 Sealant - per tooth $11.58M
90 A4222 Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) $11.50M
91 0202U Oncology (prostate), multianalyte, gene expression profiling $11.22M
92 J0585 Injection, onabotulinumtoxina, 1 unit $11.00M
93 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $10.99M
94 A0100 Non-emergency transportation; taxi $10.88M
95 80053 Comprehensive metabolic panel $10.82M
96 99215 Prolong outpt/office vis $10.78M
97 S0109 Methadone, oral, 5 mg $10.73M
98 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $10.33M
99 T2003 Non-emergency transportation; encounter/trip $10.29M
100 96158 $10.20M
101 74177 Computed tomography, abdomen and pelvis; with contrast material $10.12M
102 96127 $10.02M
103 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $9.80M
104 85025 Blood count; complete (CBC), automated, and automated differential WBC count $9.69M
105 A0425 Ground mileage, per statute mile $9.54M
106 V2020 Frames, purchases $9.29M
107 90847 Family psychotherapy with the patient present, 50 minutes $9.14M
108 87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe $8.94M
109 36415 Collection of venous blood by venipuncture $8.77M
110 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $8.55M
111 T2001 Non-emergency transportation; patient attendant/escort $8.45M
112 98940 $8.24M
113 J0178 Injection, aflibercept, 1 mg $8.17M
114 71046 Radiologic examination, chest; 2 views $8.11M
115 S9485 Crisis intervention mental health services, per diem $8.02M
116 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $8.00M
117 T1016 Case management, each 15 minutes $7.49M
118 G9012 Other specified case management service not elsewhere classified $7.44M
119 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 $7.35M
120 96361 Intravenous infusion, hydration; each additional hour $7.21M
121 D0274 Bitewings - four radiographic images $7.10M
122 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $7.00M
123 87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets $6.95M
124 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) $6.93M
125 99233 Prolong inpt eval add15 m $6.79M
126 D0150 Comprehensive oral evaluation - new or established patient $6.79M
127 J0575 Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine $6.71M
128 A7030 Full face mask used with positive airway pressure device, each $6.67M
129 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $6.65M
130 D2391 Resin-based composite - one surface, posterior, primary or permanent $6.62M
131 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $6.56M
132 0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel $6.51M
133 D1208 Topical application of fluoride, excluding varnish $6.29M
134 J0574 Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine $6.27M
135 67028 Intravitreal injection of a pharmacologic agent $6.16M
136 70450 Computed tomography, head or brain; without contrast material $6.15M
137 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $6.12M
138 99472 Subsequent inpatient pediatric critical care, per day, 2-5 years $5.97M
139 87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A $5.96M
140 96164 $5.91M
141 A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips $5.84M
142 H0017 Behavioral health; residential (hospital residential treatment program), without room and board, per diem $5.75M
143 A9277 Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system $5.69M
144 71045 Radiologic examination, chest; single view $5.63M
145 D0140 Limited oral evaluation - problem focused $5.51M
146 20610 $5.50M
147 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $5.38M
148 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis $5.07M
149 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $5.05M
150 D0272 Bitewings - two radiographic images $5.03M
151 D7240 Removal of impacted tooth - completely bony $5.03M
152 93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only $4.88M
153 E0570 Nebulizer, with compressor $4.69M
154 T2018 Habilitation, supported employment, waiver; per diem $4.64M
155 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $4.60M
156 70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences $4.58M
157 D2740 Crown - porcelain/ceramic $4.58M
158 96375 Therapeutic injection; each additional sequential IV push $4.55M
159 S0013 Esketamine, nasal spray, 1 mg $4.48M
160 99223 Prolong inpt eval add15 m $4.44M
161 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $4.43M
162 96110 Developmental screening, with scoring and documentation, per standardized instrument $4.42M
163 D0330 Panoramic radiographic image $4.35M
164 99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger $4.32M
165 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $4.32M
166 D0210 Intraoral - complete series of radiographic images $4.27M
167 99480 Subsequent intensive care, per day, low birth weight infant $4.25M
168 Q3014 Telehealth originating site facility fee $4.21M
169 H0035 Mental health partial hospitalization, treatment, less than 24 hours $4.20M
170 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $4.17M
171 Q5003 Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf) $4.15M
172 A9274 External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories $4.12M
173 A4239 Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service $4.08M
174 59025 Fetal non-stress test $4.06M
175 D3330 Endodontic therapy, molar tooth (excluding final restoration) $4.05M
176 S9977 Meals, per diem, not otherwise specified $3.93M
177 77067 Screening mammography, bilateral, including computer-aided detection $3.89M
178 87428 $3.88M
179 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $3.82M
180 G0330 Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room $3.80M
181 A7031 Face mask interface, replacement for full face mask, each $3.80M
182 D0220 Intraoral - periapical first radiographic image $3.74M
183 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $3.71M
184 T2036 Therapeutic camping, overnight, waiver; each session $3.67M
185 E0562 Humidifier, heated, used with positive airway pressure device $3.67M
186 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) $3.62M
187 T2029 Specialized medical equipment, not otherwise specified, waiver $3.53M
188 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $3.48M
189 99238 Hospital discharge day management, 30 minutes or less $3.44M
190 D0190 $3.44M
191 J1726 Injection, hydroxyprogesterone caproate, (makena), 10 mg $3.42M
192 T2016 Habilitation, residential, waiver; per diem $3.31M
193 E0603 Breast pump, electric (ac and/or dc), any type $3.20M
194 90686 $3.19M
195 93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study $3.17M
196 99231 Subsequent hospital care, per day, straightforward or low complexity $3.09M
197 T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each $3.06M
198 H0046 Mental health services, not otherwise specified $3.04M
199 T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each $3.03M
200 T1013 Sign language or oral interpretive services, per 15 minutes $3.03M