All 4,778 procedure codes billed by Medicaid providers in Michigan, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | H2015 | Comprehensive community support services, per 15 minutes | $3.66B |
| 2 | H2016 | Comprehensive community support services, per diem | $2.60B |
| 3 | T1017 | Targeted case management, each 15 minutes | $1.41B |
| 4 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $1.27B |
| 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) | $1.24B |
| 6 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $1.18B |
| 7 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $1.06B |
| 8 | 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) | $1.02B |
| 9 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $995.77M |
| 10 | 99284 | Emergency department visit for the evaluation and management, high severity | $812.13M |
| 11 | 90837 | Psychotherapy, 53 minutes with patient | $736.74M |
| 12 | S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | $649.10M |
| 13 | H0043 | Supported housing, per diem | $590.48M |
| 14 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $581.72M |
| 15 | H2014 | Skills training and development, per 15 minutes | $485.95M |
| 16 | H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | $435.03M |
| 17 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $426.44M |
| 18 | T1016 | Case management, each 15 minutes | $412.53M |
| 19 | 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 | $402.78M |
| 20 | T2022 | Case management, per month | $393.64M |
| 21 | H0039 | Assertive community treatment, face-to-face, per 15 minutes | $344.22M |
| 22 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $316.39M |
| 23 | 90834 | Psychotherapy, 45 minutes with patient | $311.78M |
| 24 | 97155 | Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes | $286.13M |
| 25 | T1040 | Medicaid certified community behavioral health clinic services, per diem | $284.43M |
| 26 | S5125 | Attendant care services; per 15 minutes | $262.49M |
| 27 | T1005 | Respite care services, up to 15 minutes | $233.12M |
| 28 | T1000 | Private duty / independent nursing service(s) - licensed, up to 15 minutes | $224.40M |
| 29 | H0032 | Mental health service plan development by non-physician | $216.53M |
| 30 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $211.95M |
| 31 | S5130 | Homemaker service, nos; per 15 minutes | $208.01M |
| 32 | H0031 | Mental health assessment, by non-physician | $205.02M |
| 33 | A0100 | Non-emergency transportation; taxi | $203.45M |
| 34 | T1015 | Clinic visit/encounter, all-inclusive | $201.39M |
| 35 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $190.18M |
| 36 | T2027 | Specialized childcare, waiver; per 15 minutes | $186.75M |
| 37 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $180.53M |
| 38 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $178.42M |
| 39 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $168.72M |
| 40 | 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 | $167.55M |
| 41 | T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | $165.72M |
| 42 | H2023 | Supported employment, per 15 minutes | $165.00M |
| 43 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $157.72M |
| 44 | 99232 | Subsequent hospital care, per day, moderate complexity | $157.70M |
| 45 | S5161 | Emergency response system; service fee, per month (excludes installation and testing) | $151.73M |
| 46 | 90791 | Psychiatric diagnostic evaluation | $150.87M |
| 47 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $145.55M |
| 48 | H0038 | Self-help/peer services, per 15 minutes | $141.78M |
| 49 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $131.58M |
| 50 | H2030 | Mental health clubhouse services, per 15 minutes | $130.73M |
| 51 | A0425 | Ground mileage, per statute mile | $129.05M |
| 52 | 99215 | Prolong outpt/office vis | $125.73M |
| 53 | D1120 | Prophylaxis - child | $123.51M |
| 54 | D0120 | Periodic oral evaluation - established patient | $117.65M |
| 55 | D1110 | Prophylaxis - adult | $112.94M |
| 56 | 99233 | Prolong inpt eval add15 m | $112.82M |
| 57 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $112.19M |
| 58 | D7140 | Extraction, erupted tooth or exposed root | $111.54M |
| 59 | 90832 | Psychotherapy, 30 minutes with patient | $111.02M |
| 60 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $109.41M |
| 61 | G0378 | Hospital observation service, per hour | $109.34M |
| 62 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $108.28M |
| 63 | 0365T | $104.79M | |
| 64 | H2011 | Crisis intervention service, per 15 minutes | $102.81M |
| 65 | 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 | $101.30M |
| 66 | 90792 | Psychiatric diagnostic evaluation with medical services | $96.90M |
| 67 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $93.14M |
| 68 | 99223 | Prolong inpt eval add15 m | $91.84M |
| 69 | S9976 | Lodging, per diem, not otherwise classified | $90.96M |
| 70 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $90.31M |
| 71 | D2930 | Prefabricated stainless steel crown - primary tooth | $88.67M |
| 72 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $87.30M |
| 73 | 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 | $85.82M |
| 74 | 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | $83.95M |
| 75 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $82.40M |
| 76 | 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | $81.09M |
| 77 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $79.55M |
| 78 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $78.85M |
| 79 | 59426 | $78.52M | |
| 80 | T2025 | Waiver services; not otherwise specified (nos) | $76.93M |
| 81 | H2021 | Community-based wrap-around services, per 15 minutes | $70.78M |
| 82 | S5126 | Attendant care services; per diem | $68.64M |
| 83 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $67.98M |
| 84 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $67.95M |
| 85 | J9271 | Injection, pembrolizumab, 1 mg | $67.89M |
| 86 | D0150 | Comprehensive oral evaluation - new or established patient | $67.60M |
| 87 | 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 | $67.57M |
| 88 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $66.84M |
| 89 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $66.72M |
| 90 | S5170 | Home delivered meals, including preparation; per meal | $66.54M |
| 91 | H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | $65.36M |
| 92 | 99402 | $65.35M | |
| 93 | D0140 | Limited oral evaluation - problem focused | $64.54M |
| 94 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $62.42M |
| 95 | 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | $61.29M |
| 96 | 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | $61.17M |
| 97 | D1206 | Topical application of fluoride varnish | $60.75M |
| 98 | D2740 | Crown - porcelain/ceramic | $59.67M |
| 99 | D1351 | Sealant - per tooth | $59.06M |
| 100 | 71046 | Radiologic examination, chest; 2 views | $58.10M |
| 101 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $56.92M |
| 102 | 70450 | Computed tomography, head or brain; without contrast material | $56.35M |
| 103 | 90853 | Group psychotherapy (other than of a multiple-family group) | $56.21M |
| 104 | T1002 | Rn services, up to 15 minutes | $55.89M |
| 105 | S5111 | Home care training, family; per session | $55.82M |
| 106 | 90847 | Family psychotherapy with the patient present, 50 minutes | $55.31M |
| 107 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $53.93M |
| 108 | 96361 | Intravenous infusion, hydration; each additional hour | $53.83M |
| 109 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $53.60M |
| 110 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $53.06M |
| 111 | T2013 | Habilitation, educational, waiver; per hour | $52.60M |
| 112 | G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | $49.91M |
| 113 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $48.40M |
| 114 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $47.92M |
| 115 | S0280 | Medical home program, comprehensive care coordination and planning, initial plan | $47.72M |
| 116 | A0130 | Non-emergency transportation: wheelchair van | $47.30M |
| 117 | H2019 | Therapeutic behavioral services, per 15 minutes | $46.94M |
| 118 | A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | $46.23M |
| 119 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $46.22M |
| 120 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $44.81M |
| 121 | 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | $44.48M |
| 122 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $44.39M |
| 123 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $44.07M |
| 124 | 99222 | Initial hospital care, per day, moderate complexity | $43.86M |
| 125 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $43.46M |
| 126 | D0210 | Intraoral - complete series of radiographic images | $43.05M |
| 127 | 96375 | Therapeutic injection; each additional sequential IV push | $42.93M |
| 128 | 99472 | Subsequent inpatient pediatric critical care, per day, 2-5 years | $42.47M |
| 129 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $42.44M |
| 130 | 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 | $40.47M |
| 131 | D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | $40.40M |
| 132 | T2003 | Non-emergency transportation; encounter/trip | $39.57M |
| 133 | T4541 | Incontinence product, disposable underpad, large, each | $38.49M |
| 134 | V2020 | Frames, purchases | $38.28M |
| 135 | S5150 | Unskilled respite care, not hospice; per 15 minutes | $38.08M |
| 136 | T2040 | Financial management, self-directed, waiver; per 15 minutes | $37.64M |
| 137 | J0178 | Injection, aflibercept, 1 mg | $37.25M |
| 138 | H0002 | Behavioral health screening to determine eligibility for admission to treatment program | $36.70M |
| 139 | A4927 | Gloves, non-sterile, per 100 | $36.36M |
| 140 | D0220 | Intraoral - periapical first radiographic image | $36.27M |
| 141 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $36.03M |
| 142 | 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | $36.00M |
| 143 | 80061 | Lipid panel | $35.93M |
| 144 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $35.91M |
| 145 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $35.76M |
| 146 | K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | $35.76M |
| 147 | 71045 | Radiologic examination, chest; single view | $35.70M |
| 148 | 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 | $35.14M |
| 149 | D0274 | Bitewings - four radiographic images | $34.81M |
| 150 | E0601 | Continuous positive airway pressure (cpap) device | $34.76M |
| 151 | 99469 | Subsequent inpatient neonatal critical care, per day, 28 days or younger | $34.32M |
| 152 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $34.21M |
| 153 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $34.15M |
| 154 | S5131 | Homemaker service, nos; per diem | $33.73M |
| 155 | 99205 | Prolong outpt/office vis | $33.53M |
| 156 | T4534 | Youth sized disposable incontinence product, protective underwear/pull-on, each | $33.03M |
| 157 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $32.82M |
| 158 | 77067 | Screening mammography, bilateral, including computer-aided detection | $32.32M |
| 159 | 59025 | Fetal non-stress test | $32.26M |
| 160 | T4523 | Adult sized disposable incontinence product, brief/diaper, large, each | $31.77M |
| 161 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $30.91M |
| 162 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $30.78M |
| 163 | H2000 | Comprehensive multidisciplinary evaluation | $30.64M |
| 164 | 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 | $30.56M |
| 165 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $30.28M |
| 166 | 97156 | $29.49M | |
| 167 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $29.48M |
| 168 | J0585 | Injection, onabotulinumtoxina, 1 unit | $29.45M |
| 169 | 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | $29.13M |
| 170 | A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | $28.97M |
| 171 | 76830 | Ultrasound, transvaginal | $28.49M |
| 172 | E0784 | External ambulatory infusion pump, insulin | $27.53M |
| 173 | A4230 | Infusion set for external insulin pump, non needle cannula type | $27.30M |
| 174 | 59514 | $27.21M | |
| 175 | S0215 | Non-emergency transportation; mileage, per mile | $26.83M |
| 176 | T4522 | Adult sized disposable incontinence product, brief/diaper, medium, each | $26.79M |
| 177 | A0998 | Ambulance response and treatment, no transport | $26.58M |
| 178 | D0230 | Intraoral - periapical each additional radiographic image | $26.35M |
| 179 | 99239 | Hospital discharge day management, more than 30 minutes | $25.83M |
| 180 | G0466 | Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 | $25.63M |
| 181 | 97151 | $25.48M | |
| 182 | T1012 | Alcohol and/or substance abuse services, skills development | $25.45M |
| 183 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $25.33M |
| 184 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $25.32M |
| 185 | J2350 | Injection, ocrelizumab, 1 mg | $24.73M |
| 186 | E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | $24.64M |
| 187 | 98942 | $24.54M | |
| 188 | D1208 | Topical application of fluoride, excluding varnish | $24.39M |
| 189 | 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | $23.84M |
| 190 | G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | $23.64M |
| 191 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $23.30M |
| 192 | 92340 | Fitting of spectacles, except for aphakia; monofocal | $23.18M |
| 193 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $23.16M |
| 194 | T2019 | Habilitation, supported employment, waiver; per 15 minutes | $23.15M |
| 195 | 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | $22.90M |
| 196 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $22.67M |
| 197 | Q5003 | Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf) | $22.63M |
| 198 | J2315 | Injection, naltrexone, depot form, 1 mg | $22.62M |
| 199 | T2028 | Specialized supply, not otherwise specified, waiver | $22.52M |
| 200 | 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | $22.43M |