All 2,388 procedure codes billed by Medicaid providers in Maine, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | T2016 | Habilitation, residential, waiver; per diem | $2.31B |
| 2 | 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 | $670.33M |
| 3 | T1015 | Clinic visit/encounter, all-inclusive | $544.68M |
| 4 | H2021 | Community-based wrap-around services, per 15 minutes | $534.41M |
| 5 | 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) | $512.52M |
| 6 | S5140 | Foster care, adult; per diem | $421.34M |
| 7 | T2021 | Day habilitation, waiver; per 15 minutes | $370.13M |
| 8 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $251.52M |
| 9 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $233.43M |
| 10 | H2012 | Behavioral health day treatment, per hour | $212.19M |
| 11 | 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) | $193.66M |
| 12 | S5125 | Attendant care services; per 15 minutes | $149.42M |
| 13 | G9012 | Other specified case management service not elsewhere classified | $147.63M |
| 14 | G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | $143.15M |
| 15 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $129.43M |
| 16 | H2015 | Comprehensive community support services, per 15 minutes | $121.43M |
| 17 | T1017 | Targeted case management, each 15 minutes | $106.75M |
| 18 | T2017 | Habilitation, residential, waiver; 15 minutes | $100.30M |
| 19 | 99284 | Emergency department visit for the evaluation and management, high severity | $92.17M |
| 20 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $87.88M |
| 21 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $82.21M |
| 22 | H2010 | Comprehensive medication services, per 15 minutes | $77.63M |
| 23 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $63.33M |
| 24 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $62.30M |
| 25 | H2011 | Crisis intervention service, per 15 minutes | $61.12M |
| 26 | H2017 | Psychosocial rehabilitation services, per 15 minutes | $53.43M |
| 27 | H0040 | Assertive community treatment program, per diem | $50.69M |
| 28 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $49.95M |
| 29 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $37.44M |
| 30 | H2036 | Alcohol and/or other drug treatment program, per diem | $32.80M |
| 31 | H2030 | Mental health clubhouse services, per 15 minutes | $31.96M |
| 32 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $31.77M |
| 33 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $30.36M |
| 34 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $30.27M |
| 35 | T2022 | Case management, per month | $28.09M |
| 36 | A0425 | Ground mileage, per statute mile | $27.84M |
| 37 | H2034 | Alcohol and/or drug abuse halfway house services, per diem | $27.84M |
| 38 | H2018 | Psychosocial rehabilitation services, per diem | $26.02M |
| 39 | 96165 | $24.86M | |
| 40 | T1013 | Sign language or oral interpretive services, per 15 minutes | $24.48M |
| 41 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $24.19M |
| 42 | 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 | $21.58M |
| 43 | S9484 | Crisis intervention mental health services, per hour | $20.69M |
| 44 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $19.36M |
| 45 | J9271 | Injection, pembrolizumab, 1 mg | $19.28M |
| 46 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $17.52M |
| 47 | D7140 | Extraction, erupted tooth or exposed root | $17.43M |
| 48 | J0178 | Injection, aflibercept, 1 mg | $14.89M |
| 49 | 96153 | $14.13M | |
| 50 | H2023 | Supported employment, per 15 minutes | $14.13M |
| 51 | 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 | $13.40M |
| 52 | G9002 | Coordinated care fee, maintenance rate | $13.37M |
| 53 | D8080 | Comprehensive orthodontic treatment of the adolescent dentition | $13.29M |
| 54 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $12.89M |
| 55 | G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | $12.12M |
| 56 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $12.00M |
| 57 | A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | $11.89M |
| 58 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $11.79M |
| 59 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $11.08M |
| 60 | 99215 | Prolong outpt/office vis | $10.83M |
| 61 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $10.44M |
| 62 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $10.40M |
| 63 | T1016 | Case management, each 15 minutes | $10.11M |
| 64 | 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 | $9.98M |
| 65 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $9.82M |
| 66 | H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | $9.66M |
| 67 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $9.49M |
| 68 | J0585 | Injection, onabotulinumtoxina, 1 unit | $9.28M |
| 69 | 71046 | Radiologic examination, chest; 2 views | $9.23M |
| 70 | D1120 | Prophylaxis - child | $9.11M |
| 71 | 70450 | Computed tomography, head or brain; without contrast material | $9.06M |
| 72 | H2033 | Multisystemic therapy for juveniles, per 15 minutes | $9.00M |
| 73 | 97130 | $8.99M | |
| 74 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $8.81M |
| 75 | T2042 | Hospice routine home care; per diem | $8.72M |
| 76 | 90837 | Psychotherapy, 53 minutes with patient | $8.43M |
| 77 | 99232 | Subsequent hospital care, per day, moderate complexity | $8.42M |
| 78 | 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 | $8.05M |
| 79 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $7.89M |
| 80 | 99408 | $7.83M | |
| 81 | H0047 | Alcohol and/or other drug abuse services, not otherwise specified | $7.82M |
| 82 | D1351 | Sealant - per tooth | $7.36M |
| 83 | T1005 | Respite care services, up to 15 minutes | $7.34M |
| 84 | G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | $7.32M |
| 85 | 76819 | Fetal biophysical profile; without non-stress testing | $7.20M |
| 86 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $7.14M |
| 87 | 90832 | Psychotherapy, 30 minutes with patient | $7.02M |
| 88 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $6.99M |
| 89 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $6.92M |
| 90 | G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | $6.73M |
| 91 | G9007 | Coordinated care fee, scheduled team conference | $6.46M |
| 92 | J1745 | Injection, infliximab, excludes biosimilar, 10 mg | $6.37M |
| 93 | D0120 | Periodic oral evaluation - established patient | $6.31M |
| 94 | 77386 | $6.28M | |
| 95 | 90834 | Psychotherapy, 45 minutes with patient | $6.22M |
| 96 | H2014 | Skills training and development, per 15 minutes | $6.12M |
| 97 | D1206 | Topical application of fluoride varnish | $6.04M |
| 98 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $6.01M |
| 99 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $5.91M |
| 100 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $5.88M |
| 101 | 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | $5.77M |
| 102 | A0436 | Rotary wing air mileage, per statute mile | $5.76M |
| 103 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $5.75M |
| 104 | D2930 | Prefabricated stainless steel crown - primary tooth | $5.67M |
| 105 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $5.64M |
| 106 | D1110 | Prophylaxis - adult | $5.50M |
| 107 | 78815 | Positron emission tomography (PET) for limited area imaging | $5.42M |
| 108 | 90853 | Group psychotherapy (other than of a multiple-family group) | $5.21M |
| 109 | 96375 | Therapeutic injection; each additional sequential IV push | $5.18M |
| 110 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $5.18M |
| 111 | 96361 | Intravenous infusion, hydration; each additional hour | $5.00M |
| 112 | 96164 | $4.98M | |
| 113 | J3380 | Injection, vedolizumab, intravenous, 1 mg | $4.95M |
| 114 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $4.85M |
| 115 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $4.84M |
| 116 | G0515 | Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes | $4.82M |
| 117 | E0784 | External ambulatory infusion pump, insulin | $4.81M |
| 118 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $4.75M |
| 119 | 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | $4.74M |
| 120 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $4.71M |
| 121 | G0008 | Administration of influenza virus vaccine | $4.55M |
| 122 | A4230 | Infusion set for external insulin pump, non needle cannula type | $4.53M |
| 123 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $4.49M |
| 124 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $4.46M |
| 125 | D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | $4.37M |
| 126 | 90791 | Psychiatric diagnostic evaluation | $4.32M |
| 127 | Q9992 | Injection, buprenorphine extended-release (sublocade), greater than 100 mg | $4.27M |
| 128 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $4.24M |
| 129 | T1026 | Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour | $4.22M |
| 130 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $4.17M |
| 131 | Q9991 | Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg | $4.15M |
| 132 | 99233 | Prolong inpt eval add15 m | $4.14M |
| 133 | B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | $4.13M |
| 134 | 77067 | Screening mammography, bilateral, including computer-aided detection | $4.03M |
| 135 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $4.03M |
| 136 | D0330 | Panoramic radiographic image | $4.01M |
| 137 | D0150 | Comprehensive oral evaluation - new or established patient | $3.93M |
| 138 | 20610 | $3.93M | |
| 139 | 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 | $3.87M |
| 140 | A7030 | Full face mask used with positive airway pressure device, each | $3.84M |
| 141 | 80053 | Comprehensive metabolic panel | $3.78M |
| 142 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $3.78M |
| 143 | D0140 | Limited oral evaluation - problem focused | $3.75M |
| 144 | E0601 | Continuous positive airway pressure (cpap) device | $3.74M |
| 145 | S5165 | Home modifications; per service | $3.72M |
| 146 | G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | $3.67M |
| 147 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $3.64M |
| 148 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $3.59M |
| 149 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $3.51M |
| 150 | 90792 | Psychiatric diagnostic evaluation with medical services | $3.46M |
| 151 | L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | $3.45M |
| 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 | $3.42M |
| 153 | D9222 | $3.33M | |
| 154 | 76705 | Ultrasound, abdominal, real time with image documentation; limited | $3.32M |
| 155 | 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 | $3.28M |
| 156 | J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | $3.19M |
| 157 | H2000 | Comprehensive multidisciplinary evaluation | $3.18M |
| 158 | 84443 | Thyroid stimulating hormone (TSH) | $3.16M |
| 159 | 71260 | Computed tomography, thorax, diagnostic; with contrast material | $3.16M |
| 160 | 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | $3.16M |
| 161 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $3.11M |
| 162 | J9299 | Injection, nivolumab, 1 mg | $3.10M |
| 163 | T2040 | Financial management, self-directed, waiver; per 15 minutes | $3.05M |
| 164 | 71045 | Radiologic examination, chest; single view | $3.02M |
| 165 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $3.00M |
| 166 | 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | $2.98M |
| 167 | 41899 | Unlisted procedure, dentoalveolar structures | $2.86M |
| 168 | 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | $2.79M |
| 169 | 77412 | $2.78M | |
| 170 | 70551 | Magnetic resonance imaging, brain; without contrast material | $2.76M |
| 171 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $2.72M |
| 172 | 80061 | Lipid panel | $2.66M |
| 173 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $2.63M |
| 174 | A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | $2.62M |
| 175 | 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | $2.61M |
| 176 | A0434 | Specialty care transport (sct) | $2.60M |
| 177 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $2.59M |
| 178 | A7031 | Face mask interface, replacement for full face mask, each | $2.57M |
| 179 | S5161 | Emergency response system; service fee, per month (excludes installation and testing) | $2.54M |
| 180 | 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | $2.44M |
| 181 | G0153 | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes | $2.42M |
| 182 | G0383 | Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | $2.41M |
| 183 | S5170 | Home delivered meals, including preparation; per meal | $2.34M |
| 184 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $2.34M |
| 185 | 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 | $2.33M |
| 186 | 67028 | Intravitreal injection of a pharmacologic agent | $2.31M |
| 187 | T1041 | Medicaid certified community behavioral health clinic services, per month | $2.26M |
| 188 | 76830 | Ultrasound, transvaginal | $2.26M |
| 189 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $2.22M |
| 190 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $2.20M |
| 191 | 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 | $2.19M |
| 192 | J2505 | Injection, pegfilgrastim, 6 mg | $2.18M |
| 193 | G0382 | Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) | $2.17M |
| 194 | 71275 | Computed tomographic angiography, chest, with contrast material | $2.15M |
| 195 | 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | $2.15M |
| 196 | 97129 | $2.07M | |
| 197 | D7240 | Removal of impacted tooth - completely bony | $2.06M |
| 198 | 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | $2.04M |
| 199 | A4604 | Tubing with integrated heating element for use with positive airway pressure device | $2.03M |
| 200 | D0274 | Bitewings - four radiographic images | $2.02M |