Medicaid Provider Spending

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

Billing Codes in Kansas

All 2,239 procedure codes billed by Medicaid providers in Kansas, ranked by total spending.

#CodeDescriptionTotal Paid
1 T2016 Habilitation, residential, waiver; per diem $1.67B
2 S5125 Attendant care services; per 15 minutes $1.17B
3 T2021 Day habilitation, waiver; per 15 minutes $805.32M
4 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) $469.67M
5 T1040 Medicaid certified community behavioral health clinic services, per diem $458.47M
6 T1000 Private duty / independent nursing service(s) - licensed, up to 15 minutes $298.70M
7 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $279.27M
8 H0036 Community psychiatric supportive treatment, face-to-face, per 15 minutes $258.60M
9 T2025 Waiver services; not otherwise specified (nos) $201.19M
10 T2046 Hospice long term care, room and board only; per diem $173.89M
11 T1017 Targeted case management, each 15 minutes $130.66M
12 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 $128.79M
13 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $119.94M
14 T2040 Financial management, self-directed, waiver; per 15 minutes $99.19M
15 H2017 Psychosocial rehabilitation services, per 15 minutes $96.33M
16 90837 Psychotherapy, 53 minutes with patient $93.70M
17 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $61.70M
18 H2011 Crisis intervention service, per 15 minutes $52.14M
19 99283 Emergency department visit for the evaluation and management, moderate severity $49.57M
20 Y7506 $42.42M
21 D1351 Sealant - per tooth $39.59M
22 99284 Emergency department visit for the evaluation and management, high severity $39.55M
23 D1120 Prophylaxis - child $39.53M
24 D1206 Topical application of fluoride varnish $38.44M
25 92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder $35.52M
26 D0120 Periodic oral evaluation - established patient $26.99M
27 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $25.93M
28 D1110 Prophylaxis - adult $25.50M
29 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $25.24M
30 S5170 Home delivered meals, including preparation; per meal $24.78M
31 90834 Psychotherapy, 45 minutes with patient $24.35M
32 97530 Therapeutic activities, direct patient contact, each 15 minutes $24.17M
33 D2930 Prefabricated stainless steel crown - primary tooth $22.67M
34 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 $22.20M
35 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $20.92M
36 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $20.80M
37 V2020 Frames, purchases $20.44M
38 00170 Anesthesia for intraoral procedures, including biopsy $19.91M
39 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $19.03M
40 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $17.62M
41 H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem $17.54M
42 S5150 Unskilled respite care, not hospice; per 15 minutes $17.38M
43 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $17.22M
44 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $17.11M
45 41899 Unlisted procedure, dentoalveolar structures $16.79M
46 S5165 Home modifications; per service $15.47M
47 G0151 Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes $15.30M
48 80053 Comprehensive metabolic panel $15.01M
49 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $14.95M
50 D7240 Removal of impacted tooth - completely bony $14.72M
51 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $14.55M
52 H0038 Self-help/peer services, per 15 minutes $14.28M
53 H2021 Community-based wrap-around services, per 15 minutes $14.11M
54 D2391 Resin-based composite - one surface, posterior, primary or permanent $14.02M
55 D7140 Extraction, erupted tooth or exposed root $13.87M
56 G0152 Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes $13.86M
57 S5161 Emergency response system; service fee, per month (excludes installation and testing) $12.95M
58 D0274 Bitewings - four radiographic images $12.93M
59 A0425 Ground mileage, per statute mile $12.28M
60 X4006 $12.07M
61 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $11.99M
62 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) $11.71M
63 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $11.55M
64 D0330 Panoramic radiographic image $11.31M
65 80050 General health panel $11.11M
66 84443 Thyroid stimulating hormone (TSH) $10.92M
67 D0272 Bitewings - two radiographic images $10.91M
68 D0150 Comprehensive oral evaluation - new or established patient $10.86M
69 80061 Lipid panel $10.77M
70 90999 Unlisted dialysis procedure, inpatient or outpatient $10.17M
71 H0004 Behavioral health counseling and therapy, per 15 minutes $10.02M
72 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $9.63M
73 S9460 Diabetic management program, nurse visit $9.50M
74 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $9.13M
75 97130 $9.09M
76 99232 Subsequent hospital care, per day, moderate complexity $9.03M
77 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $8.88M
78 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $8.83M
79 85025 Blood count; complete (CBC), automated, and automated differential WBC count $8.75M
80 90472 Immunization administration, each additional vaccine (list separately) $8.63M
81 99233 Prolong inpt eval add15 m $8.51M
82 90460 Immunization administration through 18 years of age via any route, first or only component $8.44M
83 D0140 Limited oral evaluation - problem focused $8.25M
84 87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies $7.89M
85 90832 Psychotherapy, 30 minutes with patient $7.69M
86 96110 Developmental screening, with scoring and documentation, per standardized instrument $7.65M
87 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $7.45M
88 H0005 Alcohol and/or drug services; group counseling by a clinician $7.39M
89 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $7.39M
90 99282 Emergency department visit for the evaluation and management, low to moderate severity $7.17M
91 T2003 Non-emergency transportation; encounter/trip $6.63M
92 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $6.52M
93 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $6.51M
94 G0153 Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes $6.41M
95 T1013 Sign language or oral interpretive services, per 15 minutes $6.39M
96 83036 Hemoglobin; glycosylated (A1C) $6.37M
97 88305 Level IV - Surgical pathology, gross and microscopic examination $6.29M
98 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $6.11M
99 87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe $6.01M
100 H2023 Supported employment, per 15 minutes $5.86M
101 A0100 Non-emergency transportation; taxi $5.75M
102 80081 $5.61M
103 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) $5.58M
104 V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens $5.57M
105 S0311 Comprehensive management and care coordination for advanced illness, per calendar month $5.46M
106 D0230 Intraoral - periapical each additional radiographic image $5.45M
107 D0220 Intraoral - periapical first radiographic image $5.40M
108 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $5.33M
109 D1208 Topical application of fluoride, excluding varnish $5.28M
110 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $5.14M
111 D9999 Unspecified adjunctive procedure, by report $5.09M
112 S9124 Nursing care, in the home; by licensed practical nurse, per hour $5.09M
113 D9222 $5.06M
114 S0316 Disease management program, follow-up/reassessment $4.98M
115 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $4.79M
116 81420 Fetal chromosomal aneuploidy genomic sequence analysis panel $4.79M
117 92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient $4.74M
118 T2029 Specialized medical equipment, not otherwise specified, waiver $4.67M
119 S5110 Home care training, family; per 15 minutes $4.60M
120 87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms $4.60M
121 V2100 Sphere, single vision, plano to plus or minus 4.00, per lens $4.58M
122 90791 Psychiatric diagnostic evaluation $4.55M
123 S0317 Disease management program; per diem $4.36M
124 T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each $4.34M
125 90847 Family psychotherapy with the patient present, 50 minutes $4.34M
126 X4011 State-specific procedure code $4.32M
127 X4003 $4.20M
128 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 $4.11M
129 T1027 Family training and counseling for child development, per 15 minutes $3.88M
130 87624 Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types $3.78M
131 90935 Hemodialysis procedure with single evaluation by a physician $3.69M
132 86803 $3.62M
133 99223 Prolong inpt eval add15 m $3.52M
134 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 $3.46M
135 G0463 Hospital outpatient clinic visit for assessment and management of a patient $3.46M
136 88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer $3.45M
137 92015 Determination of refractive state $3.34M
138 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 $3.28M
139 D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction $3.27M
140 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $3.25M
141 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $3.24M
142 74177 Computed tomography, abdomen and pelvis; with contrast material $3.18M
143 T2031 Assisted living; waiver, per diem $3.09M
144 86003 $3.08M
145 E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) $3.07M
146 G0515 Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes $3.03M
147 81513 $3.01M
148 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 $2.99M
149 S5135 Companion care, adult (e.g., iadl/adl); per 15 minutes $2.98M
150 E0570 Nebulizer, with compressor $2.98M
151 T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each $2.93M
152 70450 Computed tomography, head or brain; without contrast material $2.92M
153 86480 $2.87M
154 99479 Subsequent intensive care, per day, very low birth weight infant $2.86M
155 87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets $2.80M
156 87086 Culture, bacterial; quantitative colony count, urine $2.77M
157 H2014 Skills training and development, per 15 minutes $2.70M
158 99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger $2.70M
159 A0130 Non-emergency transportation: wheelchair van $2.58M
160 G9150 National committee for quality assurance - level 3 medical home $2.58M
161 V2784 Lens, polycarbonate or equal, any index, per lens $2.56M
162 82607 $2.51M
163 T4523 Adult sized disposable incontinence product, brief/diaper, large, each $2.50M
164 99402 $2.49M
165 84439 $2.48M
166 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $2.48M
167 A4554 Disposable underpads, all sizes $2.47M
168 71045 Radiologic examination, chest; single view $2.46M
169 S0281 Medical home program, comprehensive care coordination and planning, maintenance of plan $2.46M
170 97537 $2.44M
171 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 $2.41M
172 82728 $2.41M
173 T4522 Adult sized disposable incontinence product, brief/diaper, medium, each $2.40M
174 E2402 Negative pressure wound therapy electrical pump, stationary or portable $2.38M
175 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $2.33M
176 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $2.27M
177 A4353 Intermittent urinary catheter, with insertion supplies $2.24M
178 H0001 Alcohol and/or drug assessment $2.23M
179 80074 $2.22M
180 85027 $2.19M
181 99215 Prolong outpt/office vis $2.17M
182 S5130 Homemaker service, nos; per 15 minutes $2.17M
183 T4528 Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each $2.13M
184 11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm $2.11M
185 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $2.10M
186 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $2.02M
187 99309 Subsequent nursing facility care, per day, low to moderate complexity $2.02M
188 0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel $2.01M
189 99238 Hospital discharge day management, 30 minutes or less $1.99M
190 76819 Fetal biophysical profile; without non-stress testing $1.90M
191 95810 Polysomnography; sleep staging with 4 or more additional parameters $1.89M
192 83013 $1.87M
193 99308 Subsequent nursing facility care, per day, straightforward $1.84M
194 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $1.84M
195 90792 Psychiatric diagnostic evaluation with medical services $1.84M
196 D0240 $1.80M
197 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 $1.78M
198 J1559 Injection, immune globulin (hizentra), 100 mg $1.77M
199 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $1.77M
200 99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward $1.77M