All 1,929 procedure codes billed by Medicaid providers in Idaho, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | T1015 | Clinic visit/encounter, all-inclusive | $380.45M |
| 2 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $255.45M |
| 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) | $202.73M |
| 4 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $129.45M |
| 5 | H2022 | Community-based wrap-around services, per diem | $124.73M |
| 6 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $118.62M |
| 7 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $109.81M |
| 8 | H2016 | Comprehensive community support services, per diem | $107.43M |
| 9 | T2016 | Habilitation, residential, waiver; per diem | $105.53M |
| 10 | S5125 | Attendant care services; per 15 minutes | $102.11M |
| 11 | H2017 | Psychosocial rehabilitation services, per 15 minutes | $85.49M |
| 12 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $81.70M |
| 13 | 90834 | Psychotherapy, 45 minutes with patient | $71.98M |
| 14 | H2032 | Activity therapy, per 15 minutes | $65.46M |
| 15 | S5170 | Home delivered meals, including preparation; per meal | $64.53M |
| 16 | H0038 | Self-help/peer services, per 15 minutes | $49.76M |
| 17 | D0999 | Unspecified diagnostic procedure, by report | $48.40M |
| 18 | 97537 | $47.75M | |
| 19 | 96152 | $44.44M | |
| 20 | S5130 | Homemaker service, nos; per 15 minutes | $41.38M |
| 21 | T1017 | Targeted case management, each 15 minutes | $41.26M |
| 22 | S5140 | Foster care, adult; per diem | $40.31M |
| 23 | G9002 | Coordinated care fee, maintenance rate | $38.35M |
| 24 | 99284 | Emergency department visit for the evaluation and management, high severity | $37.70M |
| 25 | H2019 | Therapeutic behavioral services, per 15 minutes | $36.59M |
| 26 | D1120 | Prophylaxis - child | $35.38M |
| 27 | H2014 | Skills training and development, per 15 minutes | $34.35M |
| 28 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $33.94M |
| 29 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $31.54M |
| 30 | T2021 | Day habilitation, waiver; per 15 minutes | $26.09M |
| 31 | D1110 | Prophylaxis - adult | $25.70M |
| 32 | H2015 | Comprehensive community support services, per 15 minutes | $25.66M |
| 33 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $22.04M |
| 34 | H0035 | Mental health partial hospitalization, treatment, less than 24 hours | $21.89M |
| 35 | S5100 | Day care services, adult; per 15 minutes | $21.37M |
| 36 | H0005 | Alcohol and/or drug services; group counseling by a clinician | $20.84M |
| 37 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $20.57M |
| 38 | S5150 | Unskilled respite care, not hospice; per 15 minutes | $20.11M |
| 39 | T1013 | Sign language or oral interpretive services, per 15 minutes | $17.06M |
| 40 | T2017 | Habilitation, residential, waiver; 15 minutes | $14.79M |
| 41 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $14.58M |
| 42 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $14.13M |
| 43 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $14.10M |
| 44 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $13.71M |
| 45 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $13.52M |
| 46 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $12.67M |
| 47 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $12.24M |
| 48 | 90837 | Psychotherapy, 53 minutes with patient | $12.18M |
| 49 | 41899 | Unlisted procedure, dentoalveolar structures | $11.95M |
| 50 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $11.45M |
| 51 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $10.85M |
| 52 | D2930 | Prefabricated stainless steel crown - primary tooth | $10.26M |
| 53 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $9.99M |
| 54 | 99232 | Subsequent hospital care, per day, moderate complexity | $9.08M |
| 55 | G9007 | Coordinated care fee, scheduled team conference | $8.82M |
| 56 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $8.03M |
| 57 | A0425 | Ground mileage, per statute mile | $8.01M |
| 58 | T1002 | Rn services, up to 15 minutes | $7.96M |
| 59 | D0210 | Intraoral - complete series of radiographic images | $7.73M |
| 60 | 99215 | Prolong outpt/office vis | $7.67M |
| 61 | 90847 | Family psychotherapy with the patient present, 50 minutes | $7.64M |
| 62 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $7.13M |
| 63 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $6.77M |
| 64 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $6.71M |
| 65 | H2023 | Supported employment, per 15 minutes | $6.70M |
| 66 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $6.49M |
| 67 | 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) | $6.28M |
| 68 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $6.15M |
| 69 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $6.00M |
| 70 | D0330 | Panoramic radiographic image | $5.94M |
| 71 | 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 | $5.74M |
| 72 | 90791 | Psychiatric diagnostic evaluation | $5.48M |
| 73 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $5.40M |
| 74 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $5.28M |
| 75 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $5.17M |
| 76 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $4.97M |
| 77 | 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | $4.93M |
| 78 | S5110 | Home care training, family; per 15 minutes | $4.85M |
| 79 | T1016 | Case management, each 15 minutes | $4.80M |
| 80 | D0150 | Comprehensive oral evaluation - new or established patient | $4.64M |
| 81 | D7240 | Removal of impacted tooth - completely bony | $4.63M |
| 82 | 00170 | Anesthesia for intraoral procedures, including biopsy | $4.58M |
| 83 | 92340 | Fitting of spectacles, except for aphakia; monofocal | $4.46M |
| 84 | D5120 | $4.45M | |
| 85 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $4.33M |
| 86 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $4.12M |
| 87 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $4.03M |
| 88 | H0032 | Mental health service plan development by non-physician | $3.95M |
| 89 | A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | $3.78M |
| 90 | 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | $3.73M |
| 91 | D7140 | Extraction, erupted tooth or exposed root | $3.64M |
| 92 | J0585 | Injection, onabotulinumtoxina, 1 unit | $3.60M |
| 93 | 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 | $3.51M |
| 94 | A7030 | Full face mask used with positive airway pressure device, each | $3.48M |
| 95 | D9420 | $3.47M | |
| 96 | T1001 | Nursing assessment / evaluation | $3.46M |
| 97 | S5145 | Foster care, therapeutic, child; per diem | $3.37M |
| 98 | 92526 | $3.29M | |
| 99 | T2019 | Habilitation, supported employment, waiver; per 15 minutes | $3.17M |
| 100 | 99222 | Initial hospital care, per day, moderate complexity | $3.17M |
| 101 | 80053 | Comprehensive metabolic panel | $3.09M |
| 102 | D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | $3.08M |
| 103 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $3.04M |
| 104 | 70450 | Computed tomography, head or brain; without contrast material | $3.02M |
| 105 | T1027 | Family training and counseling for child development, per 15 minutes | $2.94M |
| 106 | 99233 | Prolong inpt eval add15 m | $2.93M |
| 107 | 99223 | Prolong inpt eval add15 m | $2.92M |
| 108 | H0031 | Mental health assessment, by non-physician | $2.85M |
| 109 | G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | $2.84M |
| 110 | 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 | $2.84M |
| 111 | 90461 | $2.81M | |
| 112 | S5161 | Emergency response system; service fee, per month (excludes installation and testing) | $2.73M |
| 113 | E0601 | Continuous positive airway pressure (cpap) device | $2.72M |
| 114 | A0100 | Non-emergency transportation; taxi | $2.69M |
| 115 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $2.67M |
| 116 | 97535 | Self-care/home management training, each 15 minutes | $2.67M |
| 117 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $2.62M |
| 118 | 92065 | $2.58M | |
| 119 | T1003 | Lpn/lvn services, up to 15 minutes | $2.57M |
| 120 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $2.54M |
| 121 | 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $2.54M |
| 122 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $2.50M |
| 123 | 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | $2.47M |
| 124 | 90472 | Immunization administration, each additional vaccine (list separately) | $2.47M |
| 125 | J1745 | Injection, infliximab, excludes biosimilar, 10 mg | $2.44M |
| 126 | A7031 | Face mask interface, replacement for full face mask, each | $2.40M |
| 127 | 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 | $2.40M |
| 128 | T1014 | Telehealth transmission, per minute, professional services bill separately | $2.39M |
| 129 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $2.33M |
| 130 | 92523 | $2.31M | |
| 131 | H0046 | Mental health services, not otherwise specified | $2.31M |
| 132 | E0603 | Breast pump, electric (ac and/or dc), any type | $2.30M |
| 133 | 99309 | Subsequent nursing facility care, per day, low to moderate complexity | $2.26M |
| 134 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $2.17M |
| 135 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $2.17M |
| 136 | 99231 | Subsequent hospital care, per day, straightforward or low complexity | $2.13M |
| 137 | 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 | $2.12M |
| 138 | H2012 | Behavioral health day treatment, per hour | $2.12M |
| 139 | S9485 | Crisis intervention mental health services, per diem | $2.10M |
| 140 | D0140 | Limited oral evaluation - problem focused | $2.09M |
| 141 | 99412 | $2.07M | |
| 142 | 90832 | Psychotherapy, 30 minutes with patient | $2.05M |
| 143 | 90846 | Family psychotherapy without the patient present, 50 minutes | $2.04M |
| 144 | D0120 | Periodic oral evaluation - established patient | $2.02M |
| 145 | E2402 | Negative pressure wound therapy electrical pump, stationary or portable | $2.00M |
| 146 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $1.94M |
| 147 | D0274 | Bitewings - four radiographic images | $1.89M |
| 148 | A4604 | Tubing with integrated heating element for use with positive airway pressure device | $1.89M |
| 149 | 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 | $1.85M |
| 150 | 84443 | Thyroid stimulating hormone (TSH) | $1.81M |
| 151 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $1.80M |
| 152 | 71045 | Radiologic examination, chest; single view | $1.79M |
| 153 | D5110 | $1.78M | |
| 154 | G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | $1.72M |
| 155 | 71046 | Radiologic examination, chest; 2 views | $1.66M |
| 156 | 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 | $1.64M |
| 157 | J2778 | Injection, ranibizumab, 0.1 mg | $1.62M |
| 158 | G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | $1.55M |
| 159 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $1.52M |
| 160 | D8670 | Periodic orthodontic treatment visit | $1.51M |
| 161 | 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 | $1.51M |
| 162 | 36415 | Collection of venous blood by venipuncture | $1.48M |
| 163 | 96131 | $1.47M | |
| 164 | D0145 | Oral evaluation for a patient under three years of age | $1.45M |
| 165 | 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | $1.44M |
| 166 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $1.42M |
| 167 | 96130 | $1.41M | |
| 168 | 92609 | $1.40M | |
| 169 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $1.39M |
| 170 | 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $1.38M |
| 171 | 99205 | Prolong outpt/office vis | $1.37M |
| 172 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $1.37M |
| 173 | E1399 | Durable medical equipment, miscellaneous | $1.36M |
| 174 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $1.35M |
| 175 | D1351 | Sealant - per tooth | $1.34M |
| 176 | J0178 | Injection, aflibercept, 1 mg | $1.33M |
| 177 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $1.30M |
| 178 | 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | $1.29M |
| 179 | 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | $1.29M |
| 180 | B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | $1.27M |
| 181 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $1.26M |
| 182 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $1.23M |
| 183 | 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | $1.21M |
| 184 | 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | $1.20M |
| 185 | 97113 | $1.20M | |
| 186 | S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | $1.19M |
| 187 | E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | $1.18M |
| 188 | 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 | $1.15M |
| 189 | 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | $1.14M |
| 190 | E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | $1.13M |
| 191 | A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | $1.13M |
| 192 | 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 | $1.11M |
| 193 | 01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | $1.11M |
| 194 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $1.10M |
| 195 | 96153 | $1.10M | |
| 196 | A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | $1.10M |
| 197 | T4541 | Incontinence product, disposable underpad, large, each | $1.07M |
| 198 | 71275 | Computed tomographic angiography, chest, with contrast material | $1.07M |
| 199 | 98942 | $1.06M | |
| 200 | E0202 | Phototherapy (bilirubin) light with photometer | $1.05M |