Medicaid Provider Spending

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

Billing Codes in Maryland

All 3,418 procedure codes billed by Medicaid providers in Maryland, ranked by total spending.

#CodeDescriptionTotal Paid
1 H0044 Supported housing, per month $1.66B
2 90834 Psychotherapy, 45 minutes with patient $1.31B
3 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $1.14B
4 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $967.78M
5 S5102 Day care services, adult; per diem $753.14M
6 T1003 Lpn/lvn services, up to 15 minutes $692.80M
7 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 $584.41M
8 H2016 Comprehensive community support services, per diem $579.69M
9 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $518.66M
10 T2022 Case management, per month $367.67M
11 Q5003 Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf) $325.55M
12 T2016 Habilitation, residential, waiver; per diem $284.04M
13 H2036 Alcohol and/or other drug treatment program, per diem $268.82M
14 H0040 Assertive community treatment program, per diem $261.37M
15 T1015 Clinic visit/encounter, all-inclusive $237.13M
16 W7350 $235.02M
17 W5102 $202.06M
18 90847 Family psychotherapy with the patient present, 50 minutes $177.47M
19 99284 Emergency department visit for the evaluation and management, high severity $176.90M
20 H0004 Behavioral health counseling and therapy, per 15 minutes $175.04M
21 W7370 $166.60M
22 T1023 Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter $159.18M
23 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $141.02M
24 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $136.59M
25 90837 Psychotherapy, 53 minutes with patient $132.00M
26 S9083 Global fee urgent care centers $128.31M
27 D1120 Prophylaxis - child $115.12M
28 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $114.73M
29 90791 Psychiatric diagnostic evaluation $110.85M
30 W7330 $109.76M
31 90832 Psychotherapy, 30 minutes with patient $108.86M
32 81416 $105.77M
33 97530 Therapeutic activities, direct patient contact, each 15 minutes $105.67M
34 H0005 Alcohol and/or drug services; group counseling by a clinician $101.55M
35 99215 Prolong outpt/office vis $96.29M
36 D0120 Periodic oral evaluation - established patient $93.33M
37 W7375 $90.00M
38 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) $89.79M
39 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $87.06M
40 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $84.30M
41 99232 Subsequent hospital care, per day, moderate complexity $79.23M
42 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $78.18M
43 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $74.59M
44 99509 Home visit for assistance with activities of daily living and personal care $70.98M
45 D1206 Topical application of fluoride varnish $69.63M
46 D1351 Sealant - per tooth $68.31M
47 D1110 Prophylaxis - adult $67.93M
48 T1017 Targeted case management, each 15 minutes $67.41M
49 D0999 Unspecified diagnostic procedure, by report $65.93M
50 99233 Prolong inpt eval add15 m $64.84M
51 W1761 $63.39M
52 92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder $62.94M
53 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $61.63M
54 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $61.54M
55 99309 Subsequent nursing facility care, per day, low to moderate complexity $60.99M
56 H0032 Mental health service plan development by non-physician $60.77M
57 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $59.82M
58 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $59.49M
59 81415 $59.35M
60 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 $58.39M
61 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 $57.37M
62 90853 Group psychotherapy (other than of a multiple-family group) $56.83M
63 T1016 Case management, each 15 minutes $56.35M
64 D2391 Resin-based composite - one surface, posterior, primary or permanent $54.47M
65 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $51.63M
66 D8670 Periodic orthodontic treatment visit $51.29M
67 H0001 Alcohol and/or drug assessment $51.28M
68 99283 Emergency department visit for the evaluation and management, moderate severity $50.79M
69 D2930 Prefabricated stainless steel crown - primary tooth $50.67M
70 41899 Unlisted procedure, dentoalveolar structures $48.93M
71 90792 Psychiatric diagnostic evaluation with medical services $47.23M
72 99308 Subsequent nursing facility care, per day, straightforward $46.49M
73 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $43.37M
74 H0025 Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) $43.26M
75 G9003 Coordinated care fee, risk adjusted high, initial $41.28M
76 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $40.61M
77 D0150 Comprehensive oral evaluation - new or established patient $39.02M
78 D7140 Extraction, erupted tooth or exposed root $36.73M
79 H0036 Community psychiatric supportive treatment, face-to-face, per 15 minutes $36.30M
80 G0378 Hospital observation service, per hour $36.29M
81 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 $35.56M
82 S5135 Companion care, adult (e.g., iadl/adl); per 15 minutes $34.99M
83 90999 Unlisted dialysis procedure, inpatient or outpatient $34.81M
84 G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes $34.45M
85 T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each $33.04M
86 H0031 Mental health assessment, by non-physician $32.15M
87 T4535 Disposable liner/shield/guard/pad/undergarment, for incontinence, each $31.88M
88 T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each $31.21M
89 A0425 Ground mileage, per statute mile $30.90M
90 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $30.43M
91 D2393 Resin-based composite - three surfaces, posterior, primary or permanent $29.95M
92 D1208 Topical application of fluoride, excluding varnish $29.17M
93 J0574 Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine $27.22M
94 G9004 Coordinated care fee, risk adjusted low, initial $26.75M
95 S9124 Nursing care, in the home; by licensed practical nurse, per hour $26.23M
96 S9088 Services provided in an urgent care center (list in addition to code for service) $26.15M
97 D0330 Panoramic radiographic image $26.02M
98 99223 Prolong inpt eval add15 m $25.54M
99 D8080 Comprehensive orthodontic treatment of the adolescent dentition $25.47M
100 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $25.26M
101 D7240 Removal of impacted tooth - completely bony $25.06M
102 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $25.06M
103 77067 Screening mammography, bilateral, including computer-aided detection $24.79M
104 T2021 Day habilitation, waiver; per 15 minutes $24.09M
105 G0151 Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes $24.04M
106 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $23.60M
107 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $23.39M
108 H0047 Alcohol and/or other drug abuse services, not otherwise specified $23.27M
109 88305 Level IV - Surgical pathology, gross and microscopic examination $22.93M
110 D0140 Limited oral evaluation - problem focused $22.33M
111 D0274 Bitewings - four radiographic images $21.99M
112 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $21.86M
113 T4541 Incontinence product, disposable underpad, large, each $21.45M
114 99205 Prolong outpt/office vis $21.07M
115 D3330 Endodontic therapy, molar tooth (excluding final restoration) $20.89M
116 T2033 Residential care, not otherwise specified (nos), waiver; per diem $20.61M
117 87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) $20.48M
118 R0070 Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen $20.41M
119 A6250 Skin sealants, protectants, moisturizers, ointments, any type, any size $20.29M
120 D0272 Bitewings - two radiographic images $19.32M
121 A4927 Gloves, non-sterile, per 100 $18.82M
122 99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years $17.75M
123 90846 Family psychotherapy without the patient present, 50 minutes $17.56M
124 T4528 Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each $17.48M
125 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $17.47M
126 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $17.36M
127 96159 $17.10M
128 74177 Computed tomography, abdomen and pelvis; with contrast material $16.71M
129 W7310 $16.60M
130 81229 $16.50M
131 87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B $16.47M
132 90670 $16.15M
133 T2003 Non-emergency transportation; encounter/trip $15.91M
134 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $15.72M
135 90836 $15.17M
136 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 $14.87M
137 J0178 Injection, aflibercept, 1 mg $14.83M
138 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $14.22M
139 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $14.17M
140 W0038 $13.78M
141 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $13.73M
142 H2014 Skills training and development, per 15 minutes $13.58M
143 W9323 $13.46M
144 90686 $13.14M
145 A4554 Disposable underpads, all sizes $13.04M
146 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $13.03M
147 V2020 Frames, purchases $12.74M
148 J2357 Injection, omalizumab, 5 mg $12.64M
149 Q5104 Injection, infliximab-abda, biosimilar, (renflexis), 10 mg $12.56M
150 H2022 Community-based wrap-around services, per diem $12.56M
151 T2025 Waiver services; not otherwise specified (nos) $12.54M
152 D2750 $12.47M
153 A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply $12.37M
154 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $12.02M
155 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) $11.61M
156 97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes $11.54M
157 D0220 Intraoral - periapical first radiographic image $11.45M
158 81420 Fetal chromosomal aneuploidy genomic sequence analysis panel $11.29M
159 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $11.29M
160 99239 Hospital discharge day management, more than 30 minutes $11.16M
161 99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years $11.08M
162 H0016 Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) $10.86M
163 70450 Computed tomography, head or brain; without contrast material $10.86M
164 D8660 $10.74M
165 S0201 Partial hospitalization services, less than 24 hours, per diem $10.72M
166 71046 Radiologic examination, chest; 2 views $10.50M
167 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $10.34M
168 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $9.87M
169 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $9.83M
170 99281 Emergency department visit for the evaluation and management, self-limited or minor $9.82M
171 J1559 Injection, immune globulin (hizentra), 100 mg $9.71M
172 T4523 Adult sized disposable incontinence product, brief/diaper, large, each $9.43M
173 93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only $9.30M
174 36415 Collection of venous blood by venipuncture $9.26M
175 G0463 Hospital outpatient clinic visit for assessment and management of a patient $9.17M
176 85025 Blood count; complete (CBC), automated, and automated differential WBC count $9.13M
177 99222 Initial hospital care, per day, moderate complexity $9.08M
178 E0601 Continuous positive airway pressure (cpap) device $9.02M
179 D8090 $8.86M
180 G0152 Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes $8.81M
181 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation $8.71M
182 80053 Comprehensive metabolic panel $8.63M
183 A5120 Skin barrier, wipes or swabs, each $8.60M
184 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 $8.57M
185 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $8.47M
186 T4524 Adult sized disposable incontinence product, brief/diaper, extra large, each $8.36M
187 71045 Radiologic examination, chest; single view $8.35M
188 S9480 Intensive outpatient psychiatric services, per diem $8.31M
189 93000 $8.26M
190 76830 Ultrasound, transvaginal $8.23M
191 S1040 Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) $8.15M
192 A4624 Tracheal suction catheter, any type other than closed system, each $8.07M
193 87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) $8.06M
194 W9306 $7.99M
195 J0572 Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine $7.99M
196 80061 Lipid panel $7.96M
197 76819 Fetal biophysical profile; without non-stress testing $7.80M
198 99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger $7.71M
199 S9131 Physical therapy; in the home, per diem $7.65M
200 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $7.64M