Medicaid Provider Spending

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

Billing Codes in Indiana

All 3,535 procedure codes billed by Medicaid providers in Indiana, ranked by total spending.

#CodeDescriptionTotal Paid
1 H2014 Skills training and development, per 15 minutes $1.67B
2 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $956.21M
3 T2016 Habilitation, residential, waiver; per diem $955.12M
4 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $896.52M
5 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $735.35M
6 H0010 Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) $728.38M
7 99284 Emergency department visit for the evaluation and management, high severity $579.82M
8 99283 Emergency department visit for the evaluation and management, moderate severity $546.12M
9 99600 Unlisted home visit service or procedure $495.06M
10 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $359.11M
11 90834 Psychotherapy, 45 minutes with patient $340.39M
12 90837 Psychotherapy, 53 minutes with patient $285.05M
13 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $198.48M
14 T1016 Case management, each 15 minutes $196.67M
15 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $179.29M
16 S5125 Attendant care services; per 15 minutes $167.73M
17 97530 Therapeutic activities, direct patient contact, each 15 minutes $154.42M
18 T1015 Clinic visit/encounter, all-inclusive $145.60M
19 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $142.44M
20 H0004 Behavioral health counseling and therapy, per 15 minutes $138.72M
21 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $134.78M
22 T2033 Residential care, not otherwise specified (nos), waiver; per diem $121.51M
23 T2022 Case management, per month $113.18M
24 99232 Subsequent hospital care, per day, moderate complexity $110.64M
25 H2016 Comprehensive community support services, per diem $110.46M
26 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 $110.08M
27 90832 Psychotherapy, 30 minutes with patient $104.13M
28 71045 Radiologic examination, chest; single view $99.77M
29 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) $97.49M
30 G0463 Hospital outpatient clinic visit for assessment and management of a patient $91.68M
31 A0425 Ground mileage, per statute mile $87.26M
32 97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes $87.06M
33 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $86.84M
34 T2020 Day habilitation, waiver; per diem $86.25M
35 90791 Psychiatric diagnostic evaluation $85.90M
36 D1110 Prophylaxis - adult $82.74M
37 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report $81.53M
38 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 $80.96M
39 74177 Computed tomography, abdomen and pelvis; with contrast material $80.23M
40 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $79.25M
41 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $78.81M
42 90853 Group psychotherapy (other than of a multiple-family group) $78.14M
43 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $76.07M
44 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $75.01M
45 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $74.35M
46 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $73.79M
47 D0120 Periodic oral evaluation - established patient $72.15M
48 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $68.42M
49 D1120 Prophylaxis - child $66.80M
50 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $65.70M
51 D2930 Prefabricated stainless steel crown - primary tooth $63.30M
52 99282 Emergency department visit for the evaluation and management, low to moderate severity $63.28M
53 99233 Prolong inpt eval add15 m $62.93M
54 T2031 Assisted living; waiver, per diem $62.93M
55 90999 Unlisted dialysis procedure, inpatient or outpatient $60.86M
56 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $59.44M
57 11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm $58.68M
58 D7140 Extraction, erupted tooth or exposed root $57.22M
59 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $54.74M
60 S5151 Unskilled respite care, not hospice; per diem $53.52M
61 D1351 Sealant - per tooth $53.41M
62 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $52.07M
63 V2020 Frames, purchases $51.59M
64 59425 $50.73M
65 99215 Prolong outpt/office vis $47.83M
66 98941 Chiropractic manipulative treatment; spinal, 3-4 regions $47.36M
67 96152 $46.92M
68 H0047 Alcohol and/or other drug abuse services, not otherwise specified $46.64M
69 59426 $46.28M
70 71046 Radiologic examination, chest; 2 views $45.74M
71 H0035 Mental health partial hospitalization, treatment, less than 24 hours $44.32M
72 D1206 Topical application of fluoride varnish $42.81M
73 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $42.49M
74 99223 Prolong inpt eval add15 m $41.22M
75 D0150 Comprehensive oral evaluation - new or established patient $40.58M
76 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $38.38M
77 88305 Level IV - Surgical pathology, gross and microscopic examination $37.89M
78 E0601 Continuous positive airway pressure (cpap) device $33.88M
79 E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) $33.30M
80 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $32.88M
81 90847 Family psychotherapy with the patient present, 50 minutes $32.59M
82 D1354 $32.38M
83 70450 Computed tomography, head or brain; without contrast material $31.93M
84 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $31.55M
85 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $31.04M
86 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $30.92M
87 D0274 Bitewings - four radiographic images $30.78M
88 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $30.61M
89 D7240 Removal of impacted tooth - completely bony $29.91M
90 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 $29.81M
91 D0140 Limited oral evaluation - problem focused $29.44M
92 D0330 Panoramic radiographic image $29.17M
93 H0031 Mental health assessment, by non-physician $28.97M
94 D0210 Intraoral - complete series of radiographic images $28.79M
95 90472 Immunization administration, each additional vaccine (list separately) $28.75M
96 T1000 Private duty / independent nursing service(s) - licensed, up to 15 minutes $28.38M
97 41899 Unlisted procedure, dentoalveolar structures $28.38M
98 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $27.36M
99 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 $26.43M
100 92015 Determination of refractive state $25.94M
101 J0585 Injection, onabotulinumtoxina, 1 unit $25.80M
102 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 $25.77M
103 D2391 Resin-based composite - one surface, posterior, primary or permanent $24.93M
104 H2032 Activity therapy, per 15 minutes $24.50M
105 90792 Psychiatric diagnostic evaluation with medical services $24.46M
106 V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens $23.84M
107 99309 Subsequent nursing facility care, per day, low to moderate complexity $23.68M
108 99222 Initial hospital care, per day, moderate complexity $23.34M
109 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $23.26M
110 H2017 Psychosocial rehabilitation services, per 15 minutes $22.95M
111 D0272 Bitewings - two radiographic images $22.63M
112 E1399 Durable medical equipment, miscellaneous $20.84M
113 T2002 Non-emergency transportation; per diem $20.79M
114 85025 Blood count; complete (CBC), automated, and automated differential WBC count $20.66M
115 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $20.47M
116 C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source $19.87M
117 A7030 Full face mask used with positive airway pressure device, each $19.75M
118 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $19.74M
119 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $19.47M
120 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 $19.36M
121 87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets $18.94M
122 D2393 Resin-based composite - three surfaces, posterior, primary or permanent $18.89M
123 S5140 Foster care, adult; per diem $18.87M
124 D1208 Topical application of fluoride, excluding varnish $18.52M
125 99472 Subsequent inpatient pediatric critical care, per day, 2-5 years $18.35M
126 96361 Intravenous infusion, hydration; each additional hour $18.15M
127 96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance $17.98M
128 80053 Comprehensive metabolic panel $17.67M
129 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $17.50M
130 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $16.93M
131 99239 Hospital discharge day management, more than 30 minutes $16.87M
132 T2015 Habilitation, prevocational, waiver; per hour $16.87M
133 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $16.69M
134 E2402 Negative pressure wound therapy electrical pump, stationary or portable $16.50M
135 S5130 Homemaker service, nos; per 15 minutes $16.34M
136 H0034 Medication training and support, per 15 minutes $15.89M
137 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $15.86M
138 97130 $15.78M
139 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $15.39M
140 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 $15.05M
141 87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) $14.75M
142 99218 $14.72M
143 92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder $14.65M
144 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 $14.63M
145 99238 Hospital discharge day management, 30 minutes or less $14.59M
146 J0178 Injection, aflibercept, 1 mg $14.36M
147 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis $14.24M
148 T2021 Day habilitation, waiver; per 15 minutes $14.07M
149 36415 Collection of venous blood by venipuncture $13.61M
150 S5170 Home delivered meals, including preparation; per meal $13.16M
151 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 $13.12M
152 D0220 Intraoral - periapical first radiographic image $13.02M
153 93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only $13.01M
154 E0562 Humidifier, heated, used with positive airway pressure device $13.00M
155 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $12.84M
156 Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml $12.79M
157 99308 Subsequent nursing facility care, per day, straightforward $12.73M
158 A0436 Rotary wing air mileage, per statute mile $12.62M
159 99231 Subsequent hospital care, per day, straightforward or low complexity $12.61M
160 99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger $12.60M
161 99221 $12.18M
162 E0260 Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress $12.17M
163 D8080 Comprehensive orthodontic treatment of the adolescent dentition $12.15M
164 E1007 Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction $11.66M
165 80050 General health panel $11.61M
166 A7031 Face mask interface, replacement for full face mask, each $11.58M
167 T1005 Respite care services, up to 15 minutes $11.58M
168 77067 Screening mammography, bilateral, including computer-aided detection $11.58M
169 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) $11.45M
170 H2034 Alcohol and/or drug abuse halfway house services, per diem $11.32M
171 96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular $11.27M
172 87804 Infectious agent antigen detection by immunoassay; Influenza, each type $11.07M
173 74176 Computed tomography, abdomen and pelvis; without contrast material $10.93M
174 T2003 Non-emergency transportation; encounter/trip $10.44M
175 80305 $10.37M
176 E0470 Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) $10.35M
177 45380 Colonoscopy, flexible; with biopsy, single or multiple $10.31M
178 95810 Polysomnography; sleep staging with 4 or more additional parameters $10.30M
179 V2100 Sphere, single vision, plano to plus or minus 4.00, per lens $10.30M
180 71275 Computed tomographic angiography, chest, with contrast material $10.06M
181 D2150 Silver amalgam - two surfaces, primary or permanent $9.89M
182 D0230 Intraoral - periapical each additional radiographic image $9.87M
183 A7034 Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap $9.85M
184 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $9.72M
185 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $9.71M
186 E0570 Nebulizer, with compressor $9.66M
187 B4034 Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $9.65M
188 42820 Tonsillectomy and adenoidectomy; younger than age 12 $9.40M
189 99205 Prolong outpt/office vis $9.24M
190 87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A $8.73M
191 J9271 Injection, pembrolizumab, 1 mg $8.72M
192 87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B $8.46M
193 H0038 Self-help/peer services, per 15 minutes $8.35M
194 J2357 Injection, omalizumab, 5 mg $8.18M
195 99480 Subsequent intensive care, per day, low birth weight infant $7.93M
196 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $7.87M
197 59025 Fetal non-stress test $7.86M
198 59430 $7.85M
199 E0431 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing $7.78M
200 A4604 Tubing with integrated heating element for use with positive airway pressure device $7.66M