Medicaid Provider Spending

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

Billing Codes in Minnesota

All 3,180 procedure codes billed by Medicaid providers in Minnesota, ranked by total spending.

#CodeDescriptionTotal Paid
1 S5140 Foster care, adult; per diem $2.22B
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) $1.92B
3 T2031 Assisted living; waiver, per diem $1.31B
4 H0044 Supported housing, per month $996.69M
5 H2035 Alcohol and/or other drug treatment program, per hour $819.34M
6 T2023 Targeted case management; per month $814.73M
7 T2016 Habilitation, residential, waiver; per diem $814.25M
8 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $712.89M
9 H2036 Alcohol and/or other drug treatment program, per diem $695.90M
10 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $660.50M
11 T1018 School-based individualized education program (iep) services, bundled $643.27M
12 90837 Psychotherapy, 53 minutes with patient $622.25M
13 H2017 Psychosocial rehabilitation services, per 15 minutes $453.20M
14 T1016 Case management, each 15 minutes $447.94M
15 H2014 Skills training and development, per 15 minutes $398.94M
16 G0463 Hospital outpatient clinic visit for assessment and management of a patient $355.39M
17 99284 Emergency department visit for the evaluation and management, high severity $341.44M
18 S5135 Companion care, adult (e.g., iadl/adl); per 15 minutes $307.48M
19 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $298.16M
20 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $294.15M
21 99283 Emergency department visit for the evaluation and management, moderate severity $287.56M
22 E0483 High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each $264.42M
23 S5130 Homemaker service, nos; per 15 minutes $246.61M
24 90834 Psychotherapy, 45 minutes with patient $225.42M
25 H0040 Assertive community treatment program, per diem $218.85M
26 T2003 Non-emergency transportation; encounter/trip $188.91M
27 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $180.85M
28 T1013 Sign language or oral interpretive services, per 15 minutes $173.47M
29 H0047 Alcohol and/or other drug abuse services, not otherwise specified $169.26M
30 H2012 Behavioral health day treatment, per hour $154.21M
31 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 $142.53M
32 S5125 Attendant care services; per 15 minutes $139.86M
33 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $139.22M
34 S5100 Day care services, adult; per 15 minutes $138.72M
35 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $129.14M
36 S0215 Non-emergency transportation; mileage, per mile $117.57M
37 E2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access $114.54M
38 97530 Therapeutic activities, direct patient contact, each 15 minutes $106.24M
39 A0425 Ground mileage, per statute mile $103.90M
40 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) $101.59M
41 H2015 Comprehensive community support services, per 15 minutes $97.32M
42 T1017 Targeted case management, each 15 minutes $94.82M
43 D0120 Periodic oral evaluation - established patient $88.74M
44 99233 Prolong inpt eval add15 m $83.68M
45 T2028 Specialized supply, not otherwise specified, waiver $80.84M
46 E0652 Pneumatic compressor, segmental home model with calibrated gradient pressure $79.60M
47 99215 Prolong outpt/office vis $78.95M
48 H0038 Self-help/peer services, per 15 minutes $76.73M
49 90999 Unlisted dialysis procedure, inpatient or outpatient $76.03M
50 D8670 Periodic orthodontic treatment visit $75.39M
51 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) $72.10M
52 90832 Psychotherapy, 30 minutes with patient $70.59M
53 H2032 Activity therapy, per 15 minutes $70.29M
54 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 $69.78M
55 S5150 Unskilled respite care, not hospice; per 15 minutes $64.96M
56 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $62.66M
57 90791 Psychiatric diagnostic evaluation $61.78M
58 D0140 Limited oral evaluation - problem focused $59.96M
59 H2019 Therapeutic behavioral services, per 15 minutes $59.89M
60 D1110 Prophylaxis - adult $59.79M
61 D7140 Extraction, erupted tooth or exposed root $59.09M
62 H0032 Mental health service plan development by non-physician $57.67M
63 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $57.35M
64 99232 Subsequent hospital care, per day, moderate complexity $57.29M
65 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $56.64M
66 T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each $52.89M
67 H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem $52.15M
68 S0302 Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) $52.12M
69 A0080 Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest $50.97M
70 T4535 Disposable liner/shield/guard/pad/undergarment, for incontinence, each $50.89M
71 T2029 Specialized medical equipment, not otherwise specified, waiver $49.55M
72 D1206 Topical application of fluoride varnish $47.98M
73 G9002 Coordinated care fee, maintenance rate $47.73M
74 T1030 Nursing care, in the home, by registered nurse, per diem $47.29M
75 X5622 $47.14M
76 S5170 Home delivered meals, including preparation; per meal $46.55M
77 H0046 Mental health services, not otherwise specified $45.96M
78 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $45.91M
79 A0100 Non-emergency transportation; taxi $43.74M
80 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $43.60M
81 T4528 Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each $43.39M
82 98941 Chiropractic manipulative treatment; spinal, 3-4 regions $43.17M
83 99282 Emergency department visit for the evaluation and management, low to moderate severity $42.79M
84 D8080 Comprehensive orthodontic treatment of the adolescent dentition $41.70M
85 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $41.50M
86 99223 Prolong inpt eval add15 m $40.37M
87 D0330 Panoramic radiographic image $40.12M
88 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $39.97M
89 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $39.39M
90 S5102 Day care services, adult; per diem $38.85M
91 S5165 Home modifications; per service $38.84M
92 T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each $38.78M
93 D1120 Prophylaxis - child $38.38M
94 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $38.36M
95 97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes $36.73M
96 T2034 Crisis intervention, waiver; per diem $36.57M
97 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $35.42M
98 36415 Collection of venous blood by venipuncture $35.25M
99 D0274 Bitewings - four radiographic images $34.63M
100 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $34.58M
101 D2930 Prefabricated stainless steel crown - primary tooth $34.23M
102 D0150 Comprehensive oral evaluation - new or established patient $33.52M
103 T4541 Incontinence product, disposable underpad, large, each $33.37M
104 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $32.55M
105 H0035 Mental health partial hospitalization, treatment, less than 24 hours $31.60M
106 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $31.60M
107 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $31.04M
108 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $30.98M
109 H0001 Alcohol and/or drug assessment $30.22M
110 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $29.95M
111 D2391 Resin-based composite - one surface, posterior, primary or permanent $29.15M
112 S0281 Medical home program, comprehensive care coordination and planning, maintenance of plan $28.33M
113 S0209 Wheelchair van, mileage, per mile $28.29M
114 V2020 Frames, purchases $28.15M
115 74177 Computed tomography, abdomen and pelvis; with contrast material $27.93M
116 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $27.54M
117 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $26.81M
118 T2039 Vehicle modifications, waiver; per service $26.57M
119 88305 Level IV - Surgical pathology, gross and microscopic examination $25.90M
120 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 $25.82M
121 B4149 Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit $25.06M
122 90847 Family psychotherapy with the patient present, 50 minutes $24.86M
123 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $24.55M
124 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $23.89M
125 T1001 Nursing assessment / evaluation $23.65M
126 T2019 Habilitation, supported employment, waiver; per 15 minutes $23.55M
127 H0031 Mental health assessment, by non-physician $23.27M
128 S5161 Emergency response system; service fee, per month (excludes installation and testing) $22.51M
129 A0130 Non-emergency transportation: wheelchair van $22.23M
130 90853 Group psychotherapy (other than of a multiple-family group) $21.29M
131 E1399 Durable medical equipment, miscellaneous $20.23M
132 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 $20.05M
133 D1351 Sealant - per tooth $19.74M
134 E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) $19.54M
135 99239 Hospital discharge day management, more than 30 minutes $19.52M
136 99309 Subsequent nursing facility care, per day, low to moderate complexity $19.45M
137 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $19.37M
138 H2016 Comprehensive community support services, per diem $19.32M
139 V5257 Hearing aid, digital, monaural, bte $18.43M
140 90460 Immunization administration through 18 years of age via any route, first or only component $18.40M
141 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 $18.27M
142 D0220 Intraoral - periapical first radiographic image $17.77M
143 92015 Determination of refractive state $17.63M
144 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $17.52M
145 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 $17.33M
146 E0482 Cough stimulating device, alternating positive and negative airway pressure $16.90M
147 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 $16.84M
148 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $16.50M
149 T1002 Rn services, up to 15 minutes $16.24M
150 D2150 Silver amalgam - two surfaces, primary or permanent $16.18M
151 T1015 Clinic visit/encounter, all-inclusive $15.89M
152 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $15.79M
153 T4544 Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each $15.59M
154 J0178 Injection, aflibercept, 1 mg $15.43M
155 V2784 Lens, polycarbonate or equal, any index, per lens $15.41M
156 A0436 Rotary wing air mileage, per statute mile $15.12M
157 70450 Computed tomography, head or brain; without contrast material $14.95M
158 S9328 Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem $14.42M
159 80053 Comprehensive metabolic panel $14.19M
160 T2017 Habilitation, residential, waiver; 15 minutes $14.08M
161 T2020 Day habilitation, waiver; per diem $14.05M
162 D0272 Bitewings - two radiographic images $13.74M
163 92340 Fitting of spectacles, except for aphakia; monofocal $13.72M
164 85025 Blood count; complete (CBC), automated, and automated differential WBC count $13.50M
165 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 $13.45M
166 S5145 Foster care, therapeutic, child; per diem $13.37M
167 S4993 Contraceptive pills for birth control $13.35M
168 99310 Prolong nursin fac eval 15m $13.02M
169 90785 $12.95M
170 99205 Prolong outpt/office vis $12.79M
171 0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel $12.70M
172 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 $12.55M
173 A4927 Gloves, non-sterile, per 100 $12.33M
174 T2021 Day habilitation, waiver; per 15 minutes $12.33M
175 T4522 Adult sized disposable incontinence product, brief/diaper, medium, each $12.30M
176 D9243 $12.29M
177 41899 Unlisted procedure, dentoalveolar structures $12.28M
178 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $12.17M
179 D0230 Intraoral - periapical each additional radiographic image $11.88M
180 J0585 Injection, onabotulinumtoxina, 1 unit $11.80M
181 71046 Radiologic examination, chest; 2 views $11.70M
182 T4523 Adult sized disposable incontinence product, brief/diaper, large, each $11.68M
183 T4534 Youth sized disposable incontinence product, protective underwear/pull-on, each $11.64M
184 B9998 Noc for enteral supplies $11.60M
185 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $11.17M
186 99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward $11.15M
187 B4150 Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit $11.11M
188 90846 Family psychotherapy without the patient present, 50 minutes $10.80M
189 87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe $10.79M
190 T2013 Habilitation, educational, waiver; per hour $10.59M
191 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $10.53M
192 S0280 Medical home program, comprehensive care coordination and planning, initial plan $10.37M
193 59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care $10.34M
194 S5120 Chore services; per 15 minutes $10.32M
195 V5261 Hearing aid, digital, binaural, bte $10.22M
196 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $10.12M
197 99509 Home visit for assistance with activities of daily living and personal care $10.07M
198 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $9.93M
199 E0603 Breast pump, electric (ac and/or dc), any type $9.75M
200 S8121 Oxygen contents, liquid, 1 unit equals 1 pound $9.48M