All 3,922 procedure codes billed by Medicaid providers in Kentucky, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | S5108 | Home care training to home care client, per 15 minutes | $1.67B |
| 2 | T2016 | Habilitation, residential, waiver; per diem | $1.66B |
| 3 | 97535 | Self-care/home management training, each 15 minutes | $1.12B |
| 4 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $990.83M |
| 5 | 99284 | Emergency department visit for the evaluation and management, high severity | $859.45M |
| 6 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $611.16M |
| 7 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $603.70M |
| 8 | 90837 | Psychotherapy, 53 minutes with patient | $566.38M |
| 9 | 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) | $565.18M |
| 10 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $565.03M |
| 11 | T2023 | Targeted case management; per month | $553.57M |
| 12 | H0011 | Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) | $506.15M |
| 13 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $331.80M |
| 14 | T2022 | Case management, per month | $328.28M |
| 15 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $266.44M |
| 16 | T2021 | Day habilitation, waiver; per 15 minutes | $258.91M |
| 17 | H2027 | Psychoeducational service, per 15 minutes | $247.24M |
| 18 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $232.95M |
| 19 | H0038 | Self-help/peer services, per 15 minutes | $226.69M |
| 20 | S5100 | Day care services, adult; per 15 minutes | $196.73M |
| 21 | 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 | $181.72M |
| 22 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $166.01M |
| 23 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $161.31M |
| 24 | T2040 | Financial management, self-directed, waiver; per 15 minutes | $152.31M |
| 25 | H2020 | Therapeutic behavioral services, per diem | $151.89M |
| 26 | 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 | $138.49M |
| 27 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $128.21M |
| 28 | 90832 | Psychotherapy, 30 minutes with patient | $125.33M |
| 29 | 70450 | Computed tomography, head or brain; without contrast material | $123.05M |
| 30 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $122.43M |
| 31 | H0035 | Mental health partial hospitalization, treatment, less than 24 hours | $121.90M |
| 32 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $121.15M |
| 33 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $118.71M |
| 34 | H2034 | Alcohol and/or drug abuse halfway house services, per diem | $115.86M |
| 35 | H2015 | Comprehensive community support services, per 15 minutes | $114.20M |
| 36 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $112.23M |
| 37 | G0378 | Hospital observation service, per hour | $108.84M |
| 38 | D1120 | Prophylaxis - child | $97.64M |
| 39 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $96.50M |
| 40 | T1025 | Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per diem | $94.50M |
| 41 | 99232 | Subsequent hospital care, per day, moderate complexity | $90.55M |
| 42 | 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 | $90.31M |
| 43 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $88.25M |
| 44 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $85.19M |
| 45 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $82.73M |
| 46 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $80.15M |
| 47 | H2019 | Therapeutic behavioral services, per 15 minutes | $79.29M |
| 48 | J9271 | Injection, pembrolizumab, 1 mg | $78.21M |
| 49 | 90834 | Psychotherapy, 45 minutes with patient | $77.01M |
| 50 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $76.74M |
| 51 | 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 | $75.86M |
| 52 | 41899 | Unlisted procedure, dentoalveolar structures | $72.57M |
| 53 | 80053 | Comprehensive metabolic panel | $71.34M |
| 54 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $70.06M |
| 55 | 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 | $69.51M |
| 56 | 90887 | $67.49M | |
| 57 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $67.47M |
| 58 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $67.03M |
| 59 | T1005 | Respite care services, up to 15 minutes | $64.73M |
| 60 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $64.09M |
| 61 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $63.51M |
| 62 | D0150 | Comprehensive oral evaluation - new or established patient | $61.90M |
| 63 | T1016 | Case management, each 15 minutes | $61.14M |
| 64 | 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $60.26M |
| 65 | 96375 | Therapeutic injection; each additional sequential IV push | $60.16M |
| 66 | 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 | $58.58M |
| 67 | 71045 | Radiologic examination, chest; single view | $58.29M |
| 68 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $56.64M |
| 69 | T4541 | Incontinence product, disposable underpad, large, each | $55.93M |
| 70 | 96361 | Intravenous infusion, hydration; each additional hour | $54.76M |
| 71 | 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | $53.44M |
| 72 | 71046 | Radiologic examination, chest; 2 views | $50.93M |
| 73 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $49.79M |
| 74 | T1026 | Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour | $49.40M |
| 75 | 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | $49.17M |
| 76 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $47.95M |
| 77 | C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | $47.17M |
| 78 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $47.03M |
| 79 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $46.62M |
| 80 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $46.48M |
| 81 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $45.81M |
| 82 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $44.74M |
| 83 | 99233 | Prolong inpt eval add15 m | $44.74M |
| 84 | D0330 | Panoramic radiographic image | $44.06M |
| 85 | D7140 | Extraction, erupted tooth or exposed root | $43.97M |
| 86 | D8080 | Comprehensive orthodontic treatment of the adolescent dentition | $43.07M |
| 87 | S9128 | Speech therapy, in the home, per diem | $42.91M |
| 88 | 90791 | Psychiatric diagnostic evaluation | $42.90M |
| 89 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $42.75M |
| 90 | A0425 | Ground mileage, per statute mile | $42.65M |
| 91 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $42.63M |
| 92 | 36415 | Collection of venous blood by venipuncture | $42.24M |
| 93 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $42.14M |
| 94 | D1110 | Prophylaxis - adult | $41.09M |
| 95 | 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | $40.43M |
| 96 | H0032 | Mental health service plan development by non-physician | $40.41M |
| 97 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $39.82M |
| 98 | 71275 | Computed tomographic angiography, chest, with contrast material | $38.31M |
| 99 | 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | $38.00M |
| 100 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $37.93M |
| 101 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $37.33M |
| 102 | D2930 | Prefabricated stainless steel crown - primary tooth | $36.80M |
| 103 | 92340 | Fitting of spectacles, except for aphakia; monofocal | $36.61M |
| 104 | Q5001 | Hospice or home health care provided in patient's home/residence | $35.77M |
| 105 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $35.26M |
| 106 | A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | $34.96M |
| 107 | S9083 | Global fee urgent care centers | $34.53M |
| 108 | 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | $33.67M |
| 109 | 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | $33.50M |
| 110 | 71260 | Computed tomography, thorax, diagnostic; with contrast material | $33.41M |
| 111 | 0202U | Oncology (prostate), multianalyte, gene expression profiling | $33.37M |
| 112 | A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | $32.44M |
| 113 | 72125 | Computed tomography, cervical spine; without contrast material | $32.31M |
| 114 | S9129 | Occupational therapy, in the home, per diem | $31.67M |
| 115 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $31.44M |
| 116 | 76705 | Ultrasound, abdominal, real time with image documentation; limited | $30.93M |
| 117 | 90853 | Group psychotherapy (other than of a multiple-family group) | $29.70M |
| 118 | V2020 | Frames, purchases | $29.30M |
| 119 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $29.04M |
| 120 | G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | $28.70M |
| 121 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $28.66M |
| 122 | 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | $28.27M |
| 123 | H2029 | Sexual offender treatment service, per diem | $28.20M |
| 124 | 93458 | $28.01M | |
| 125 | T1000 | Private duty / independent nursing service(s) - licensed, up to 15 minutes | $28.00M |
| 126 | H2012 | Behavioral health day treatment, per hour | $27.56M |
| 127 | H2021 | Community-based wrap-around services, per 15 minutes | $27.32M |
| 128 | D0120 | Periodic oral evaluation - established patient | $27.02M |
| 129 | 99223 | Prolong inpt eval add15 m | $26.44M |
| 130 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $26.26M |
| 131 | 99354 | $25.97M | |
| 132 | 77067 | Screening mammography, bilateral, including computer-aided detection | $25.83M |
| 133 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $25.52M |
| 134 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $25.25M |
| 135 | T1007 | Alcohol and/or substance abuse services, treatment plan development and/or modification | $25.07M |
| 136 | C1776 | Joint device (implantable) | $25.02M |
| 137 | 70551 | Magnetic resonance imaging, brain; without contrast material | $24.94M |
| 138 | E1399 | Durable medical equipment, miscellaneous | $24.92M |
| 139 | S9485 | Crisis intervention mental health services, per diem | $24.89M |
| 140 | H2018 | Psychosocial rehabilitation services, per diem | $24.77M |
| 141 | 84443 | Thyroid stimulating hormone (TSH) | $24.24M |
| 142 | D7240 | Removal of impacted tooth - completely bony | $24.09M |
| 143 | H0031 | Mental health assessment, by non-physician | $24.08M |
| 144 | Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | $23.81M |
| 145 | 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | $23.50M |
| 146 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $23.14M |
| 147 | 77386 | $23.13M | |
| 148 | 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | $22.79M |
| 149 | 71250 | $22.44M | |
| 150 | 90792 | Psychiatric diagnostic evaluation with medical services | $22.14M |
| 151 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $21.94M |
| 152 | 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 | $21.85M |
| 153 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $21.57M |
| 154 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $21.01M |
| 155 | D8670 | Periodic orthodontic treatment visit | $20.92M |
| 156 | 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | $20.77M |
| 157 | 80061 | Lipid panel | $20.75M |
| 158 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $20.63M |
| 159 | 99215 | Prolong outpt/office vis | $20.45M |
| 160 | 73630 | $20.31M | |
| 161 | 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $20.27M |
| 162 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $20.27M |
| 163 | H0040 | Assertive community treatment program, per diem | $20.15M |
| 164 | D1208 | Topical application of fluoride, excluding varnish | $19.55M |
| 165 | 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | $19.34M |
| 166 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $19.23M |
| 167 | S5170 | Home delivered meals, including preparation; per meal | $19.19M |
| 168 | 78815 | Positron emission tomography (PET) for limited area imaging | $18.97M |
| 169 | 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | $18.89M |
| 170 | 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | $18.85M |
| 171 | E0784 | External ambulatory infusion pump, insulin | $18.77M |
| 172 | 73721 | Magnetic resonance imaging, any joint of lower extremity; without contrast material | $18.76M |
| 173 | 90847 | Family psychotherapy with the patient present, 50 minutes | $18.54M |
| 174 | 93017 | $18.50M | |
| 175 | 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | $18.45M |
| 176 | 76830 | Ultrasound, transvaginal | $18.42M |
| 177 | 47562 | $18.30M | |
| 178 | 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | $18.18M |
| 179 | 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | $18.14M |
| 180 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $17.87M |
| 181 | J0585 | Injection, onabotulinumtoxina, 1 unit | $17.76M |
| 182 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $17.74M |
| 183 | D0274 | Bitewings - four radiographic images | $17.58M |
| 184 | 59025 | Fetal non-stress test | $17.55M |
| 185 | D1206 | Topical application of fluoride varnish | $17.20M |
| 186 | D0272 | Bitewings - two radiographic images | $16.78M |
| 187 | G2087 | Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month | $16.78M |
| 188 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $16.76M |
| 189 | 87428 | $16.74M | |
| 190 | H0002 | Behavioral health screening to determine eligibility for admission to treatment program | $16.68M |
| 191 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $16.66M |
| 192 | 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | $16.65M |
| 193 | H2017 | Psychosocial rehabilitation services, per 15 minutes | $16.63M |
| 194 | 72131 | $16.53M | |
| 195 | A0398 | Als routine disposable supplies | $16.10M |
| 196 | J9299 | Injection, nivolumab, 1 mg | $16.01M |
| 197 | D0140 | Limited oral evaluation - problem focused | $15.53M |
| 198 | 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | $15.35M |
| 199 | J1745 | Injection, infliximab, excludes biosimilar, 10 mg | $15.27M |
| 200 | J3490 | Unclassified drugs | $15.25M |