All 4,548 procedure codes billed by Medicaid providers in New Jersey, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | H2016 | Comprehensive community support services, per diem | $8.69B |
| 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) | $4.24B |
| 3 | S5102 | Day care services, adult; per diem | $2.10B |
| 4 | T2021 | Day habilitation, waiver; per 15 minutes | $1.68B |
| 5 | T1018 | School-based individualized education program (iep) services, bundled | $1.63B |
| 6 | 99284 | Emergency department visit for the evaluation and management, high severity | $1.28B |
| 7 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $1.08B |
| 8 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $1.06B |
| 9 | T2023 | Targeted case management; per month | $997.43M |
| 10 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $839.30M |
| 11 | 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 | $777.95M |
| 12 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $739.53M |
| 13 | T1003 | Lpn/lvn services, up to 15 minutes | $722.12M |
| 14 | H0035 | Mental health partial hospitalization, treatment, less than 24 hours | $717.70M |
| 15 | H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | $615.24M |
| 16 | 99361 | Medical team conference with interdisciplinary team of health care professionals | $610.21M |
| 17 | H2021 | Community-based wrap-around services, per 15 minutes | $596.03M |
| 18 | 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 | $530.67M |
| 19 | G0378 | Hospital observation service, per hour | $512.55M |
| 20 | T2024 | Service assessment/plan of care development, waiver | $490.63M |
| 21 | 90834 | Psychotherapy, 45 minutes with patient | $454.51M |
| 22 | T2046 | Hospice long term care, room and board only; per diem | $430.72M |
| 23 | T2031 | Assisted living; waiver, per diem | $365.67M |
| 24 | T1002 | Rn services, up to 15 minutes | $349.93M |
| 25 | T1041 | Medicaid certified community behavioral health clinic services, per month | $269.01M |
| 26 | S9124 | Nursing care, in the home; by licensed practical nurse, per hour | $266.94M |
| 27 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $232.05M |
| 28 | S9485 | Crisis intervention mental health services, per diem | $221.55M |
| 29 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $207.31M |
| 30 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $200.89M |
| 31 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $182.92M |
| 32 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $180.32M |
| 33 | G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) | $171.07M |
| 34 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $168.86M |
| 35 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $164.27M |
| 36 | H0040 | Assertive community treatment program, per diem | $163.67M |
| 37 | T1015 | Clinic visit/encounter, all-inclusive | $160.43M |
| 38 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $155.21M |
| 39 | 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 | $155.11M |
| 40 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $146.93M |
| 41 | T1017 | Targeted case management, each 15 minutes | $134.89M |
| 42 | H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | $127.94M |
| 43 | 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) | $127.67M |
| 44 | H2015 | Comprehensive community support services, per 15 minutes | $126.35M |
| 45 | 90792 | Psychiatric diagnostic evaluation with medical services | $125.81M |
| 46 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $120.52M |
| 47 | 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 | $116.88M |
| 48 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $113.93M |
| 49 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $113.48M |
| 50 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $111.63M |
| 51 | 99232 | Subsequent hospital care, per day, moderate complexity | $108.37M |
| 52 | 90853 | Group psychotherapy (other than of a multiple-family group) | $107.36M |
| 53 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $103.75M |
| 54 | H0039 | Assertive community treatment, face-to-face, per 15 minutes | $102.96M |
| 55 | D0120 | Periodic oral evaluation - established patient | $102.43M |
| 56 | 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 | $102.31M |
| 57 | T2033 | Residential care, not otherwise specified (nos), waiver; per diem | $102.04M |
| 58 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $99.88M |
| 59 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $97.69M |
| 60 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $95.49M |
| 61 | S9480 | Intensive outpatient psychiatric services, per diem | $95.38M |
| 62 | 90935 | Hemodialysis procedure with single evaluation by a physician | $95.25M |
| 63 | D1120 | Prophylaxis - child | $94.35M |
| 64 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $92.07M |
| 65 | 80053 | Comprehensive metabolic panel | $86.37M |
| 66 | 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | $83.51M |
| 67 | 90832 | Psychotherapy, 30 minutes with patient | $82.48M |
| 68 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $78.52M |
| 69 | 99215 | Prolong outpt/office vis | $74.92M |
| 70 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $72.70M |
| 71 | 90791 | Psychiatric diagnostic evaluation | $72.55M |
| 72 | 41899 | Unlisted procedure, dentoalveolar structures | $72.30M |
| 73 | OP250 | $72.19M | |
| 74 | H2014 | Skills training and development, per 15 minutes | $72.19M |
| 75 | 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | $70.95M |
| 76 | 80050 | General health panel | $70.77M |
| 77 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $70.16M |
| 78 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $69.12M |
| 79 | T1024 | Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter | $67.78M |
| 80 | 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 | $67.48M |
| 81 | 70450 | Computed tomography, head or brain; without contrast material | $66.72M |
| 82 | D1110 | Prophylaxis - adult | $64.93M |
| 83 | 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 | $63.40M |
| 84 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $62.18M |
| 85 | 80061 | Lipid panel | $61.69M |
| 86 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $61.62M |
| 87 | 90847 | Family psychotherapy with the patient present, 50 minutes | $57.78M |
| 88 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $57.64M |
| 89 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $56.79M |
| 90 | 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 | $56.39M |
| 91 | J1745 | Injection, infliximab, excludes biosimilar, 10 mg | $56.07M |
| 92 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $54.61M |
| 93 | 99233 | Prolong inpt eval add15 m | $54.38M |
| 94 | D1351 | Sealant - per tooth | $54.12M |
| 95 | L3000 | Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each | $53.80M |
| 96 | J9271 | Injection, pembrolizumab, 1 mg | $53.54M |
| 97 | T2025 | Waiver services; not otherwise specified (nos) | $53.24M |
| 98 | 96375 | Therapeutic injection; each additional sequential IV push | $52.47M |
| 99 | 86480 | $52.16M | |
| 100 | H0046 | Mental health services, not otherwise specified | $52.02M |
| 101 | 77067 | Screening mammography, bilateral, including computer-aided detection | $51.46M |
| 102 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $50.98M |
| 103 | D8670 | Periodic orthodontic treatment visit | $50.87M |
| 104 | A0090 | Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest | $49.68M |
| 105 | OP710 | $49.07M | |
| 106 | T2034 | Crisis intervention, waiver; per diem | $48.82M |
| 107 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $47.36M |
| 108 | T2015 | Habilitation, prevocational, waiver; per hour | $46.98M |
| 109 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $46.67M |
| 110 | A0425 | Ground mileage, per statute mile | $45.52M |
| 111 | D1206 | Topical application of fluoride varnish | $44.69M |
| 112 | 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | $44.51M |
| 113 | 86769 | $44.42M | |
| 114 | T2019 | Habilitation, supported employment, waiver; per 15 minutes | $43.89M |
| 115 | 84443 | Thyroid stimulating hormone (TSH) | $43.57M |
| 116 | 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | $42.75M |
| 117 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $42.70M |
| 118 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $42.10M |
| 119 | S9083 | Global fee urgent care centers | $41.41M |
| 120 | T2020 | Day habilitation, waiver; per diem | $41.24M |
| 121 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $40.03M |
| 122 | 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $39.60M |
| 123 | 83036 | Hemoglobin; glycosylated (A1C) | $38.85M |
| 124 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $38.57M |
| 125 | 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | $38.38M |
| 126 | 59025 | Fetal non-stress test | $37.83M |
| 127 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $37.74M |
| 128 | OP370 | $37.64M | |
| 129 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $37.26M |
| 130 | T2042 | Hospice routine home care; per diem | $36.70M |
| 131 | V5261 | Hearing aid, digital, binaural, bte | $36.49M |
| 132 | D2751 | Crown - porcelain fused to predominantly base metal | $36.27M |
| 133 | 71046 | Radiologic examination, chest; 2 views | $36.16M |
| 134 | 76830 | Ultrasound, transvaginal | $35.84M |
| 135 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $35.48M |
| 136 | OP272 | $34.92M | |
| 137 | 81220 | CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants | $34.46M |
| 138 | D3330 | Endodontic therapy, molar tooth (excluding final restoration) | $33.92M |
| 139 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $33.60M |
| 140 | 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | $32.47M |
| 141 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $32.45M |
| 142 | 96361 | Intravenous infusion, hydration; each additional hour | $32.02M |
| 143 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $32.02M |
| 144 | 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | $31.69M |
| 145 | 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | $31.24M |
| 146 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $30.20M |
| 147 | 93017 | $30.04M | |
| 148 | 99223 | Prolong inpt eval add15 m | $29.81M |
| 149 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $29.79M |
| 150 | 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | $28.98M |
| 151 | A0434 | Specialty care transport (sct) | $28.71M |
| 152 | 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | $28.57M |
| 153 | 76819 | Fetal biophysical profile; without non-stress testing | $28.30M |
| 154 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $27.98M |
| 155 | D0140 | Limited oral evaluation - problem focused | $27.59M |
| 156 | 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | $27.51M |
| 157 | 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | $27.03M |
| 158 | 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | $26.93M |
| 159 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $26.74M |
| 160 | 71045 | Radiologic examination, chest; single view | $26.14M |
| 161 | D0150 | Comprehensive oral evaluation - new or established patient | $26.11M |
| 162 | D7240 | Removal of impacted tooth - completely bony | $25.96M |
| 163 | D2930 | Prefabricated stainless steel crown - primary tooth | $25.76M |
| 164 | T1030 | Nursing care, in the home, by registered nurse, per diem | $25.40M |
| 165 | 93970 | $24.94M | |
| 166 | S5100 | Day care services, adult; per 15 minutes | $24.93M |
| 167 | 90837 | Psychotherapy, 53 minutes with patient | $24.81M |
| 168 | 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 | $24.74M |
| 169 | S5161 | Emergency response system; service fee, per month (excludes installation and testing) | $24.74M |
| 170 | 99281 | Emergency department visit for the evaluation and management, self-limited or minor | $24.48M |
| 171 | 82607 | $24.43M | |
| 172 | 81420 | Fetal chromosomal aneuploidy genomic sequence analysis panel | $24.40M |
| 173 | D9999 | Unspecified adjunctive procedure, by report | $24.20M |
| 174 | E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | $24.05M |
| 175 | A4554 | Disposable underpads, all sizes | $23.69M |
| 176 | D0210 | Intraoral - complete series of radiographic images | $23.53M |
| 177 | 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | $23.50M |
| 178 | 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | $23.25M |
| 179 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $22.88M |
| 180 | 70551 | Magnetic resonance imaging, brain; without contrast material | $22.74M |
| 181 | 87481 | $22.57M | |
| 182 | 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | $22.52M |
| 183 | 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | $22.48M |
| 184 | D2740 | Crown - porcelain/ceramic | $22.34M |
| 185 | D1208 | Topical application of fluoride, excluding varnish | $22.11M |
| 186 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $21.45M |
| 187 | 0202U | Oncology (prostate), multianalyte, gene expression profiling | $21.39M |
| 188 | 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | $21.31M |
| 189 | 86803 | $21.10M | |
| 190 | G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | $20.93M |
| 191 | 93458 | $20.78M | |
| 192 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $20.77M |
| 193 | 97535 | Self-care/home management training, each 15 minutes | $20.74M |
| 194 | D7140 | Extraction, erupted tooth or exposed root | $20.57M |
| 195 | 87536 | $20.54M | |
| 196 | 99309 | Subsequent nursing facility care, per day, low to moderate complexity | $19.92M |
| 197 | C1713 | Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) | $19.66M |
| 198 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $19.50M |
| 199 | A4657 | Syringe, with or without needle, each | $19.35M |
| 200 | 99222 | Initial hospital care, per day, moderate complexity | $19.15M |