Medicaid Provider Spending

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

Billing Codes in North Dakota

All 1,353 procedure codes billed by Medicaid providers in North Dakota, ranked by total spending.

#CodeDescriptionTotal Paid
1 T2016 Habilitation, residential, waiver; per diem $407.99M
2 W0725 $247.85M
3 T2021 Day habilitation, waiver; per 15 minutes $172.51M
4 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $102.56M
5 W0715 $95.99M
6 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $71.03M
7 W0300 $51.59M
8 S5125 Attendant care services; per 15 minutes $48.14M
9 99284 Emergency department visit for the evaluation and management, high severity $47.44M
10 99283 Emergency department visit for the evaluation and management, moderate severity $39.83M
11 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $38.18M
12 97530 Therapeutic activities, direct patient contact, each 15 minutes $25.93M
13 S5111 Home care training, family; per session $25.17M
14 T2019 Habilitation, supported employment, waiver; per 15 minutes $24.82M
15 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $23.70M
16 H2036 Alcohol and/or other drug treatment program, per diem $23.67M
17 G0463 Hospital outpatient clinic visit for assessment and management of a patient $23.21M
18 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $21.65M
19 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $21.27M
20 W0700 $19.04M
21 W0500 $18.14M
22 90837 Psychotherapy, 53 minutes with patient $17.85M
23 A0425 Ground mileage, per statute mile $16.17M
24 W0260 $15.50M
25 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) $15.46M
26 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $14.06M
27 S0201 Partial hospitalization services, less than 24 hours, per diem $13.06M
28 T2025 Waiver services; not otherwise specified (nos) $12.41M
29 T2017 Habilitation, residential, waiver; 15 minutes $12.29M
30 T2031 Assisted living; waiver, per diem $11.98M
31 W0200 $11.36M
32 90834 Psychotherapy, 45 minutes with patient $11.10M
33 99232 Subsequent hospital care, per day, moderate complexity $11.00M
34 T2047 Habilitation, prevocational, waiver; per 15 minutes $10.87M
35 90999 Unlisted dialysis procedure, inpatient or outpatient $10.69M
36 W0720 $9.32M
37 Q3014 Telehealth originating site facility fee $8.89M
38 T2024 Service assessment/plan of care development, waiver $8.80M
39 T1015 Clinic visit/encounter, all-inclusive $8.61M
40 H0016 Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) $8.56M
41 W0710 $8.48M
42 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 $7.33M
43 H0035 Mental health partial hospitalization, treatment, less than 24 hours $7.21M
44 W0510 $7.19M
45 98941 Chiropractic manipulative treatment; spinal, 3-4 regions $6.74M
46 99233 Prolong inpt eval add15 m $6.55M
47 H0004 Behavioral health counseling and therapy, per 15 minutes $6.53M
48 S9480 Intensive outpatient psychiatric services, per diem $6.33M
49 W0530 $5.98M
50 99282 Emergency department visit for the evaluation and management, low to moderate severity $5.55M
51 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 $5.49M
52 00042 $5.20M
53 D0120 Periodic oral evaluation - established patient $5.04M
54 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $4.94M
55 S9475 Ambulatory setting substance abuse treatment or detoxification services, per diem $4.43M
56 T1016 Case management, each 15 minutes $4.37M
57 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $4.32M
58 99215 Prolong outpt/office vis $4.26M
59 W0705 $4.21M
60 99223 Prolong inpt eval add15 m $4.21M
61 A0100 Non-emergency transportation; taxi $4.17M
62 T1017 Targeted case management, each 15 minutes $4.08M
63 88305 Level IV - Surgical pathology, gross and microscopic examination $4.00M
64 H2035 Alcohol and/or other drug treatment program, per hour $3.92M
65 D1120 Prophylaxis - child $3.77M
66 J0585 Injection, onabotulinumtoxina, 1 unit $3.46M
67 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $3.33M
68 T1023 Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter $3.30M
69 H2018 Psychosocial rehabilitation services, per diem $3.22M
70 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) $3.20M
71 S0215 Non-emergency transportation; mileage, per mile $3.12M
72 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $3.05M
73 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $3.03M
74 512 $2.93M
75 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $2.92M
76 74177 Computed tomography, abdomen and pelvis; with contrast material $2.91M
77 A4520 Incontinence garment, any type, (e.g., brief, diaper), each $2.82M
78 90853 Group psychotherapy (other than of a multiple-family group) $2.81M
79 S0302 Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) $2.78M
80 A0436 Rotary wing air mileage, per statute mile $2.78M
81 D2930 Prefabricated stainless steel crown - primary tooth $2.63M
82 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $2.58M
83 D1206 Topical application of fluoride varnish $2.53M
84 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $2.52M
85 W0230 $2.45M
86 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $2.43M
87 W0520 $2.42M
88 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $2.42M
89 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 $2.41M
90 S5126 Attendant care services; per diem $2.39M
91 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $2.33M
92 99239 Hospital discharge day management, more than 30 minutes $2.33M
93 80053 Comprehensive metabolic panel $2.32M
94 H2010 Comprehensive medication services, per 15 minutes $2.30M
95 T2023 Targeted case management; per month $2.29M
96 A0435 Fixed wing air mileage, per statute mile $2.22M
97 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $2.16M
98 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 $2.14M
99 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $2.11M
100 92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient $2.01M
101 H2017 Psychosocial rehabilitation services, per 15 minutes $2.00M
102 D1110 Prophylaxis - adult $1.95M
103 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $1.88M
104 36415 Collection of venous blood by venipuncture $1.88M
105 D0140 Limited oral evaluation - problem focused $1.85M
106 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $1.67M
107 62323 $1.65M
108 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $1.64M
109 H2014 Skills training and development, per 15 minutes $1.63M
110 92015 Determination of refractive state $1.61M
111 90832 Psychotherapy, 30 minutes with patient $1.60M
112 D7140 Extraction, erupted tooth or exposed root $1.60M
113 D0150 Comprehensive oral evaluation - new or established patient $1.59M
114 D2391 Resin-based composite - one surface, posterior, primary or permanent $1.58M
115 90791 Psychiatric diagnostic evaluation $1.53M
116 90472 Immunization administration, each additional vaccine (list separately) $1.52M
117 96361 Intravenous infusion, hydration; each additional hour $1.48M
118 T1002 Rn services, up to 15 minutes $1.48M
119 99309 Subsequent nursing facility care, per day, low to moderate complexity $1.47M
120 90792 Psychiatric diagnostic evaluation with medical services $1.45M
121 H0002 Behavioral health screening to determine eligibility for admission to treatment program $1.43M
122 A0080 Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest $1.43M
123 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $1.40M
124 D1351 Sealant - per tooth $1.38M
125 A0998 Ambulance response and treatment, no transport $1.35M
126 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 $1.35M
127 A0120 Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems $1.35M
128 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $1.33M
129 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $1.33M
130 93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only $1.32M
131 98940 $1.30M
132 71045 Radiologic examination, chest; single view $1.27M
133 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $1.26M
134 H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem $1.25M
135 77067 Screening mammography, bilateral, including computer-aided detection $1.23M
136 70450 Computed tomography, head or brain; without contrast material $1.21M
137 S5150 Unskilled respite care, not hospice; per 15 minutes $1.20M
138 99222 Initial hospital care, per day, moderate complexity $1.19M
139 0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel $1.18M
140 W0730 $1.18M
141 E0601 Continuous positive airway pressure (cpap) device $1.17M
142 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $1.15M
143 S5135 Companion care, adult (e.g., iadl/adl); per 15 minutes $1.14M
144 D7240 Removal of impacted tooth - completely bony $1.12M
145 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $1.12M
146 D8090 $1.09M
147 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $1.05M
148 85025 Blood count; complete (CBC), automated, and automated differential WBC count $1.05M
149 71046 Radiologic examination, chest; 2 views $1.03M
150 T1030 Nursing care, in the home, by registered nurse, per diem $1.02M
151 D0272 Bitewings - two radiographic images $976K
152 64615 $966K
153 92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder $935K
154 90785 $899K
155 D1208 Topical application of fluoride, excluding varnish $894K
156 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 $865K
157 99238 Hospital discharge day management, 30 minutes or less $818K
158 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $787K
159 84443 Thyroid stimulating hormone (TSH) $768K
160 D9222 $762K
161 D0274 Bitewings - four radiographic images $750K
162 G0378 Hospital observation service, per hour $742K
163 G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes $742K
164 92340 Fitting of spectacles, except for aphakia; monofocal $741K
165 H2011 Crisis intervention service, per 15 minutes $740K
166 D0330 Panoramic radiographic image $739K
167 99231 Subsequent hospital care, per day, straightforward or low complexity $733K
168 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $727K
169 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 $724K
170 A7030 Full face mask used with positive airway pressure device, each $717K
171 A0130 Non-emergency transportation: wheelchair van $704K
172 A0170 Transportation ancillary: parking fees, tolls, other $695K
173 96375 Therapeutic injection; each additional sequential IV push $694K
174 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $688K
175 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $676K
176 H2015 Comprehensive community support services, per 15 minutes $676K
177 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $674K
178 80061 Lipid panel $673K
179 67028 Intravitreal injection of a pharmacologic agent $673K
180 90847 Family psychotherapy with the patient present, 50 minutes $659K
181 80050 General health panel $644K
182 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $637K
183 88307 $616K
184 W0210 $602K
185 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $599K
186 90460 Immunization administration through 18 years of age via any route, first or only component $582K
187 S0209 Wheelchair van, mileage, per mile $567K
188 D9420 $543K
189 99308 Subsequent nursing facility care, per day, straightforward $543K
190 H0037 Community psychiatric supportive treatment program, per diem $542K
191 99205 Prolong outpt/office vis $527K
192 A4230 Infusion set for external insulin pump, non needle cannula type $523K
193 T2003 Non-emergency transportation; encounter/trip $519K
194 S5130 Homemaker service, nos; per 15 minutes $518K
195 J0178 Injection, aflibercept, 1 mg $516K
196 00015 $512K
197 96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular $510K
198 A7031 Face mask interface, replacement for full face mask, each $505K
199 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $496K
200 41899 Unlisted procedure, dentoalveolar structures $478K