All 4,097 procedure codes billed by Medicaid providers in Massachusetts, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | T2016 | Habilitation, residential, waiver; per diem | $8.97B |
| 2 | 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) | $8.43B |
| 3 | S5140 | Foster care, adult; per diem | $3.11B |
| 4 | S5102 | Day care services, adult; per diem | $1.42B |
| 5 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $1.06B |
| 6 | 90834 | Psychotherapy, 45 minutes with patient | $969.90M |
| 7 | T1502 | Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit | $952.50M |
| 8 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $873.20M |
| 9 | T2025 | Waiver services; not otherwise specified (nos) | $864.72M |
| 10 | T1015 | Clinic visit/encounter, all-inclusive | $851.72M |
| 11 | H2018 | Psychosocial rehabilitation services, per diem | $839.30M |
| 12 | H2019 | Therapeutic behavioral services, per 15 minutes | $819.97M |
| 13 | G0156 | Services of home health/hospice aide in home health or hospice settings, each 15 minutes | $709.13M |
| 14 | H2015 | Comprehensive community support services, per 15 minutes | $699.51M |
| 15 | T2046 | Hospice long term care, room and board only; per diem | $670.41M |
| 16 | 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 | $628.02M |
| 17 | S5130 | Homemaker service, nos; per 15 minutes | $616.11M |
| 18 | T2023 | Targeted case management; per month | $600.31M |
| 19 | S5100 | Day care services, adult; per 15 minutes | $590.95M |
| 20 | H0043 | Supported housing, per diem | $561.18M |
| 21 | 99284 | Emergency department visit for the evaluation and management, high severity | $558.93M |
| 22 | H2014 | Skills training and development, per 15 minutes | $558.92M |
| 23 | T2003 | Non-emergency transportation; encounter/trip | $548.67M |
| 24 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $539.39M |
| 25 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $531.47M |
| 26 | G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | $482.71M |
| 27 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $477.13M |
| 28 | 99509 | Home visit for assistance with activities of daily living and personal care | $438.83M |
| 29 | T1002 | Rn services, up to 15 minutes | $392.53M |
| 30 | 96361 | Intravenous infusion, hydration; each additional hour | $370.14M |
| 31 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $368.86M |
| 32 | S9485 | Crisis intervention mental health services, per diem | $365.98M |
| 33 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $306.65M |
| 34 | T1040 | Medicaid certified community behavioral health clinic services, per diem | $303.21M |
| 35 | H0023 | Behavioral health outreach service (planned approach to reach a targeted population) | $303.11M |
| 36 | 90837 | Psychotherapy, 53 minutes with patient | $296.03M |
| 37 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $293.54M |
| 38 | T1027 | Family training and counseling for child development, per 15 minutes | $267.20M |
| 39 | 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) | $248.33M |
| 40 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $225.69M |
| 41 | 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) | $215.27M |
| 42 | T1003 | Lpn/lvn services, up to 15 minutes | $213.59M |
| 43 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $203.35M |
| 44 | T2022 | Case management, per month | $195.90M |
| 45 | S5125 | Attendant care services; per 15 minutes | $186.30M |
| 46 | D1110 | Prophylaxis - adult | $174.69M |
| 47 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $173.11M |
| 48 | D8670 | Periodic orthodontic treatment visit | $169.54M |
| 49 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $161.45M |
| 50 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $153.31M |
| 51 | S5170 | Home delivered meals, including preparation; per meal | $152.89M |
| 52 | 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 | $138.60M |
| 53 | D2740 | Crown - porcelain/ceramic | $138.30M |
| 54 | S5131 | Homemaker service, nos; per diem | $131.82M |
| 55 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $129.52M |
| 56 | G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | $127.97M |
| 57 | H2023 | Supported employment, per 15 minutes | $127.96M |
| 58 | D1120 | Prophylaxis - child | $124.94M |
| 59 | S5161 | Emergency response system; service fee, per month (excludes installation and testing) | $124.39M |
| 60 | H2016 | Comprehensive community support services, per diem | $121.54M |
| 61 | T1024 | Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter | $119.09M |
| 62 | D0120 | Periodic oral evaluation - established patient | $118.54M |
| 63 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $116.50M |
| 64 | 99215 | Prolong outpt/office vis | $112.87M |
| 65 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $112.86M |
| 66 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $110.95M |
| 67 | T2021 | Day habilitation, waiver; per 15 minutes | $108.02M |
| 68 | S5101 | Day care services, adult; per half day | $106.63M |
| 69 | H0011 | Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) | $105.05M |
| 70 | 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 | $103.59M |
| 71 | S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | $101.03M |
| 72 | H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | $95.55M |
| 73 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $93.70M |
| 74 | G0378 | Hospital observation service, per hour | $93.54M |
| 75 | H2011 | Crisis intervention service, per 15 minutes | $89.44M |
| 76 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $85.16M |
| 77 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $84.67M |
| 78 | S0340 | Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage | $84.32M |
| 79 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $80.81M |
| 80 | A0425 | Ground mileage, per statute mile | $78.93M |
| 81 | 70450 | Computed tomography, head or brain; without contrast material | $78.52M |
| 82 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $77.28M |
| 83 | D9450 | $76.03M | |
| 84 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $75.25M |
| 85 | T2019 | Habilitation, supported employment, waiver; per 15 minutes | $74.35M |
| 86 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $73.19M |
| 87 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $71.75M |
| 88 | D0274 | Bitewings - four radiographic images | $70.05M |
| 89 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $69.20M |
| 90 | 41899 | Unlisted procedure, dentoalveolar structures | $69.13M |
| 91 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $68.52M |
| 92 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $67.17M |
| 93 | J9271 | Injection, pembrolizumab, 1 mg | $65.71M |
| 94 | 90791 | Psychiatric diagnostic evaluation | $63.98M |
| 95 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $61.93M |
| 96 | G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit | $61.64M |
| 97 | H2012 | Behavioral health day treatment, per hour | $60.43M |
| 98 | 90832 | Psychotherapy, 30 minutes with patient | $60.21M |
| 99 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $58.48M |
| 100 | H0040 | Assertive community treatment program, per diem | $56.25M |
| 101 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $55.85M |
| 102 | D1206 | Topical application of fluoride varnish | $55.68M |
| 103 | 99350 | Prolong home eval add 15m | $52.21M |
| 104 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $51.31M |
| 105 | D7140 | Extraction, erupted tooth or exposed root | $51.21M |
| 106 | 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | $51.21M |
| 107 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $50.30M |
| 108 | H0031 | Mental health assessment, by non-physician | $50.07M |
| 109 | 90887 | $49.78M | |
| 110 | 99233 | Prolong inpt eval add15 m | $48.93M |
| 111 | 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | $48.86M |
| 112 | 99232 | Subsequent hospital care, per day, moderate complexity | $48.60M |
| 113 | D0150 | Comprehensive oral evaluation - new or established patient | $48.56M |
| 114 | D0140 | Limited oral evaluation - problem focused | $47.95M |
| 115 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $47.37M |
| 116 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $47.22M |
| 117 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $45.63M |
| 118 | D1351 | Sealant - per tooth | $45.55M |
| 119 | H0032 | Mental health service plan development by non-physician | $44.21M |
| 120 | 59025 | Fetal non-stress test | $43.91M |
| 121 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $43.17M |
| 122 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $42.84M |
| 123 | 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | $42.60M |
| 124 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $42.37M |
| 125 | 77067 | Screening mammography, bilateral, including computer-aided detection | $41.71M |
| 126 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $41.68M |
| 127 | D1208 | Topical application of fluoride, excluding varnish | $41.43M |
| 128 | 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 | $41.21M |
| 129 | 96110 | Developmental screening, with scoring and documentation, per standardized instrument | $41.15M |
| 130 | 81220 | CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants | $39.74M |
| 131 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $39.49M |
| 132 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $39.31M |
| 133 | 90882 | $39.24M | |
| 134 | 77063 | Screening digital breast tomosynthesis, bilateral | $39.18M |
| 135 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $39.17M |
| 136 | A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | $38.68M |
| 137 | D8080 | Comprehensive orthodontic treatment of the adolescent dentition | $37.85M |
| 138 | D0220 | Intraoral - periapical first radiographic image | $37.15M |
| 139 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $37.11M |
| 140 | 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | $37.10M |
| 141 | S5175 | Laundry service, external, professional; per order | $36.44M |
| 142 | 71046 | Radiologic examination, chest; 2 views | $36.31M |
| 143 | 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | $36.27M |
| 144 | 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 | $36.27M |
| 145 | 92340 | Fitting of spectacles, except for aphakia; monofocal | $35.94M |
| 146 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $35.68M |
| 147 | A0130 | Non-emergency transportation: wheelchair van | $35.47M |
| 148 | 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 | $33.74M |
| 149 | E0603 | Breast pump, electric (ac and/or dc), any type | $32.79M |
| 150 | D0330 | Panoramic radiographic image | $32.02M |
| 151 | 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | $31.55M |
| 152 | H2036 | Alcohol and/or other drug treatment program, per diem | $31.41M |
| 153 | S0341 | Lifestyle modification program for management of coronary artery disease, including all supportive services; second or third quarter / stage | $31.28M |
| 154 | D0210 | Intraoral - complete series of radiographic images | $31.18M |
| 155 | 76830 | Ultrasound, transvaginal | $30.82M |
| 156 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $30.56M |
| 157 | D2930 | Prefabricated stainless steel crown - primary tooth | $30.55M |
| 158 | D7240 | Removal of impacted tooth - completely bony | $30.31M |
| 159 | 99456 | $30.27M | |
| 160 | 96415 | $30.14M | |
| 161 | J1745 | Injection, infliximab, excludes biosimilar, 10 mg | $29.66M |
| 162 | G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | $29.30M |
| 163 | 97155 | Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes | $29.15M |
| 164 | 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | $28.72M |
| 165 | 99223 | Prolong inpt eval add15 m | $28.07M |
| 166 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $28.06M |
| 167 | 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | $27.02M |
| 168 | V2020 | Frames, purchases | $26.04M |
| 169 | 76705 | Ultrasound, abdominal, real time with image documentation; limited | $25.75M |
| 170 | S0215 | Non-emergency transportation; mileage, per mile | $25.64M |
| 171 | 84443 | Thyroid stimulating hormone (TSH) | $25.61M |
| 172 | H0035 | Mental health partial hospitalization, treatment, less than 24 hours | $25.58M |
| 173 | A4353 | Intermittent urinary catheter, with insertion supplies | $25.08M |
| 174 | J0585 | Injection, onabotulinumtoxina, 1 unit | $24.64M |
| 175 | 80053 | Comprehensive metabolic panel | $24.58M |
| 176 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $24.56M |
| 177 | 93971 | $24.26M | |
| 178 | 90847 | Family psychotherapy with the patient present, 50 minutes | $23.98M |
| 179 | T2040 | Financial management, self-directed, waiver; per 15 minutes | $23.37M |
| 180 | D3330 | Endodontic therapy, molar tooth (excluding final restoration) | $23.15M |
| 181 | A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | $23.15M |
| 182 | 70551 | Magnetic resonance imaging, brain; without contrast material | $23.09M |
| 183 | 90853 | Group psychotherapy (other than of a multiple-family group) | $22.99M |
| 184 | D0272 | Bitewings - two radiographic images | $22.63M |
| 185 | 78815 | Positron emission tomography (PET) for limited area imaging | $22.54M |
| 186 | 99309 | Subsequent nursing facility care, per day, low to moderate complexity | $22.50M |
| 187 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $22.23M |
| 188 | 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | $22.05M |
| 189 | 76700 | Ultrasound, abdominal, real time with image documentation; complete | $22.04M |
| 190 | G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | $21.44M |
| 191 | D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | $21.32M |
| 192 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $21.24M |
| 193 | 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 | $20.94M |
| 194 | J9035 | Injection, bevacizumab, 10 mg | $20.72M |
| 195 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $20.48M |
| 196 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $20.43M |
| 197 | 71275 | Computed tomographic angiography, chest, with contrast material | $20.19M |
| 198 | A0170 | Transportation ancillary: parking fees, tolls, other | $20.09M |
| 199 | 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | $19.89M |
| 200 | S9342 | Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | $19.69M |