All 1,870 procedure codes billed by Medicaid providers in Montana, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | S5126 | Attendant care services; per diem | $1.78B |
| 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) | $553.05M |
| 3 | T2017 | Habilitation, residential, waiver; 15 minutes | $276.94M |
| 4 | S5150 | Unskilled respite care, not hospice; per 15 minutes | $234.03M |
| 5 | 90837 | Psychotherapy, 53 minutes with patient | $172.43M |
| 6 | H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | $147.10M |
| 7 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $119.56M |
| 8 | T2021 | Day habilitation, waiver; per 15 minutes | $118.11M |
| 9 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $102.76M |
| 10 | S5145 | Foster care, therapeutic, child; per diem | $98.50M |
| 11 | S5136 | Companion care, adult (e.g., iadl/adl); per diem | $93.95M |
| 12 | T2031 | Assisted living; waiver, per diem | $89.31M |
| 13 | T2013 | Habilitation, educational, waiver; per hour | $87.63M |
| 14 | T1016 | Case management, each 15 minutes | $73.78M |
| 15 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $61.71M |
| 16 | S5102 | Day care services, adult; per diem | $57.43M |
| 17 | H0040 | Assertive community treatment program, per diem | $54.99M |
| 18 | T2022 | Case management, per month | $54.70M |
| 19 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $40.61M |
| 20 | 99284 | Emergency department visit for the evaluation and management, high severity | $35.33M |
| 21 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $32.97M |
| 22 | T2016 | Habilitation, residential, waiver; per diem | $32.14M |
| 23 | H2012 | Behavioral health day treatment, per hour | $30.22M |
| 24 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $28.97M |
| 25 | H2019 | Therapeutic behavioral services, per 15 minutes | $27.36M |
| 26 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $24.76M |
| 27 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $22.72M |
| 28 | T2032 | Residential care, not otherwise specified (nos), waiver; per month | $20.93M |
| 29 | H2020 | Therapeutic behavioral services, per diem | $20.60M |
| 30 | 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 | $18.66M |
| 31 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $16.08M |
| 32 | D1120 | Prophylaxis - child | $15.88M |
| 33 | G2021 | Health care practitioners rendering treatment in place (tip) | $15.58M |
| 34 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $15.34M |
| 35 | T1002 | Rn services, up to 15 minutes | $15.16M |
| 36 | D0120 | Periodic oral evaluation - established patient | $15.10M |
| 37 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $14.11M |
| 38 | D1206 | Topical application of fluoride varnish | $14.07M |
| 39 | D8670 | Periodic orthodontic treatment visit | $13.41M |
| 40 | 99215 | Prolong outpt/office vis | $13.40M |
| 41 | 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 | $13.04M |
| 42 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $11.90M |
| 43 | D1110 | Prophylaxis - adult | $11.88M |
| 44 | H0032 | Mental health service plan development by non-physician | $11.54M |
| 45 | D2930 | Prefabricated stainless steel crown - primary tooth | $11.35M |
| 46 | D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | $11.29M |
| 47 | H0037 | Community psychiatric supportive treatment program, per diem | $10.43M |
| 48 | S5100 | Day care services, adult; per 15 minutes | $10.03M |
| 49 | S9485 | Crisis intervention mental health services, per diem | $9.83M |
| 50 | H0016 | Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) | $9.65M |
| 51 | H2025 | Ongoing support to maintain employment, per 15 minutes | $9.15M |
| 52 | 90834 | Psychotherapy, 45 minutes with patient | $8.83M |
| 53 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $8.39M |
| 54 | S5140 | Foster care, adult; per diem | $8.36M |
| 55 | S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | $8.27M |
| 56 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $7.85M |
| 57 | D7240 | Removal of impacted tooth - completely bony | $7.75M |
| 58 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $7.71M |
| 59 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $7.60M |
| 60 | A0430 | Ambulance service, conventional air services, transport, one way (fixed wing) | $7.49M |
| 61 | 99232 | Subsequent hospital care, per day, moderate complexity | $7.47M |
| 62 | T1003 | Lpn/lvn services, up to 15 minutes | $7.41M |
| 63 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $7.12M |
| 64 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $7.07M |
| 65 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $7.07M |
| 66 | 90791 | Psychiatric diagnostic evaluation | $7.01M |
| 67 | 41899 | Unlisted procedure, dentoalveolar structures | $6.72M |
| 68 | D0367 | $6.55M | |
| 69 | 90832 | Psychotherapy, 30 minutes with patient | $6.49M |
| 70 | D1351 | Sealant - per tooth | $6.38M |
| 71 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $6.32M |
| 72 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $6.23M |
| 73 | D1310 | $6.22M | |
| 74 | H0038 | Self-help/peer services, per 15 minutes | $6.00M |
| 75 | T2033 | Residential care, not otherwise specified (nos), waiver; per diem | $5.89M |
| 76 | A0435 | Fixed wing air mileage, per statute mile | $5.74M |
| 77 | D9999 | Unspecified adjunctive procedure, by report | $5.60M |
| 78 | 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | $5.56M |
| 79 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $5.37M |
| 80 | 90853 | Group psychotherapy (other than of a multiple-family group) | $5.36M |
| 81 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $5.33M |
| 82 | D0330 | Panoramic radiographic image | $5.21M |
| 83 | H0012 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient) | $5.16M |
| 84 | 99233 | Prolong inpt eval add15 m | $4.89M |
| 85 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $4.85M |
| 86 | D7140 | Extraction, erupted tooth or exposed root | $4.84M |
| 87 | D0274 | Bitewings - four radiographic images | $4.78M |
| 88 | 92340 | Fitting of spectacles, except for aphakia; monofocal | $4.70M |
| 89 | D0272 | Bitewings - two radiographic images | $4.68M |
| 90 | 92015 | Determination of refractive state | $4.67M |
| 91 | T2002 | Non-emergency transportation; per diem | $4.53M |
| 92 | D8080 | Comprehensive orthodontic treatment of the adolescent dentition | $4.36M |
| 93 | D0150 | Comprehensive oral evaluation - new or established patient | $3.88M |
| 94 | D0140 | Limited oral evaluation - problem focused | $3.87M |
| 95 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $3.75M |
| 96 | D9222 | $3.62M | |
| 97 | D1330 | $3.61M | |
| 98 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $3.56M |
| 99 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $3.55M |
| 100 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $3.45M |
| 101 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $3.38M |
| 102 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $3.33M |
| 103 | D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | $3.28M |
| 104 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $3.23M |
| 105 | 00170 | Anesthesia for intraoral procedures, including biopsy | $3.19M |
| 106 | T2001 | Non-emergency transportation; patient attendant/escort | $3.17M |
| 107 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $3.08M |
| 108 | 90792 | Psychiatric diagnostic evaluation with medical services | $3.05M |
| 109 | T2003 | Non-emergency transportation; encounter/trip | $3.04M |
| 110 | S5125 | Attendant care services; per 15 minutes | $3.03M |
| 111 | E0601 | Continuous positive airway pressure (cpap) device | $2.89M |
| 112 | D9310 | $2.89M | |
| 113 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $2.84M |
| 114 | 70450 | Computed tomography, head or brain; without contrast material | $2.82M |
| 115 | D2740 | Crown - porcelain/ceramic | $2.78M |
| 116 | A4927 | Gloves, non-sterile, per 100 | $2.78M |
| 117 | A0382 | Bls routine disposable supplies | $2.73M |
| 118 | H2034 | Alcohol and/or drug abuse halfway house services, per diem | $2.71M |
| 119 | 99205 | Prolong outpt/office vis | $2.71M |
| 120 | 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | $2.71M |
| 121 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $2.70M |
| 122 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $2.61M |
| 123 | D9243 | $2.55M | |
| 124 | Q3014 | Telehealth originating site facility fee | $2.52M |
| 125 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $2.51M |
| 126 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $2.47M |
| 127 | H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | $2.46M |
| 128 | A0425 | Ground mileage, per statute mile | $2.37M |
| 129 | A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | $2.31M |
| 130 | D9248 | $2.26M | |
| 131 | T2028 | Specialized supply, not otherwise specified, waiver | $2.22M |
| 132 | 90847 | Family psychotherapy with the patient present, 50 minutes | $2.21M |
| 133 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $2.19M |
| 134 | 99223 | Prolong inpt eval add15 m | $2.18M |
| 135 | A0398 | Als routine disposable supplies | $2.18M |
| 136 | 82075 | $2.14M | |
| 137 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $2.12M |
| 138 | D0220 | Intraoral - periapical first radiographic image | $2.09M |
| 139 | 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 | $2.09M |
| 140 | D0603 | $2.06M | |
| 141 | A0380 | Bls mileage (per mile) | $1.92M |
| 142 | A7030 | Full face mask used with positive airway pressure device, each | $1.87M |
| 143 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $1.86M |
| 144 | S9484 | Crisis intervention mental health services, per hour | $1.86M |
| 145 | D7230 | $1.83M | |
| 146 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $1.80M |
| 147 | 90472 | Immunization administration, each additional vaccine (list separately) | $1.80M |
| 148 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $1.80M |
| 149 | H0046 | Mental health services, not otherwise specified | $1.77M |
| 150 | B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | $1.72M |
| 151 | 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | $1.70M |
| 152 | H2015 | Comprehensive community support services, per 15 minutes | $1.64M |
| 153 | E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | $1.63M |
| 154 | A0436 | Rotary wing air mileage, per statute mile | $1.62M |
| 155 | D4341 | $1.60M | |
| 156 | E2402 | Negative pressure wound therapy electrical pump, stationary or portable | $1.58M |
| 157 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $1.58M |
| 158 | G0378 | Hospital observation service, per hour | $1.57M |
| 159 | 95811 | $1.56M | |
| 160 | A4604 | Tubing with integrated heating element for use with positive airway pressure device | $1.54M |
| 161 | 71046 | Radiologic examination, chest; 2 views | $1.49M |
| 162 | 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | $1.49M |
| 163 | D9920 | $1.46M | |
| 164 | D9630 | $1.45M | |
| 165 | D0350 | $1.45M | |
| 166 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $1.45M |
| 167 | D0425 | $1.37M | |
| 168 | 80053 | Comprehensive metabolic panel | $1.36M |
| 169 | A7031 | Face mask interface, replacement for full face mask, each | $1.35M |
| 170 | S5130 | Homemaker service, nos; per 15 minutes | $1.29M |
| 171 | 99222 | Initial hospital care, per day, moderate complexity | $1.28M |
| 172 | 99239 | Hospital discharge day management, more than 30 minutes | $1.25M |
| 173 | 71045 | Radiologic examination, chest; single view | $1.24M |
| 174 | 90846 | Family psychotherapy without the patient present, 50 minutes | $1.24M |
| 175 | D0145 | Oral evaluation for a patient under three years of age | $1.24M |
| 176 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $1.21M |
| 177 | T4537 | Incontinence product, protective underpad, reusable, bed size, each | $1.18M |
| 178 | D9612 | $1.15M | |
| 179 | 77067 | Screening mammography, bilateral, including computer-aided detection | $1.15M |
| 180 | S9480 | Intensive outpatient psychiatric services, per diem | $1.14M |
| 181 | G0330 | Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room | $1.12M |
| 182 | H2032 | Activity therapy, per 15 minutes | $1.12M |
| 183 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $1.09M |
| 184 | 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | $1.07M |
| 185 | S4993 | Contraceptive pills for birth control | $1.06M |
| 186 | 92250 | $1.06M | |
| 187 | A0394 | Als specialized service disposable supplies; iv drug therapy | $1.06M |
| 188 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $1.02M |
| 189 | 90839 | $1.02M | |
| 190 | D1354 | $1.02M | |
| 191 | D2751 | Crown - porcelain fused to predominantly base metal | $1.02M |
| 192 | D2929 | $1.01M | |
| 193 | 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $1.01M |
| 194 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $999K |
| 195 | D9239 | $994K | |
| 196 | 88307 | $989K | |
| 197 | T4541 | Incontinence product, disposable underpad, large, each | $982K |
| 198 | A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | $978K |
| 199 | 93303 | Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study | $976K |
| 200 | D0240 | $972K |