Medicaid Provider Spending

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

Billing Codes in New Mexico

All 3,066 procedure codes billed by Medicaid providers in New Mexico, ranked by total spending.

#CodeDescriptionTotal Paid
1 99509 Home visit for assistance with activities of daily living and personal care $1.34B
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) $1.18B
3 T2016 Habilitation, residential, waiver; per diem $883.72M
4 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $486.82M
5 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $472.35M
6 T2033 Residential care, not otherwise specified (nos), waiver; per diem $421.56M
7 90837 Psychotherapy, 53 minutes with patient $334.14M
8 99284 Emergency department visit for the evaluation and management, high severity $299.02M
9 H2021 Community-based wrap-around services, per 15 minutes $270.71M
10 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $247.97M
11 T1027 Family training and counseling for child development, per 15 minutes $206.96M
12 99283 Emergency department visit for the evaluation and management, moderate severity $203.58M
13 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $197.08M
14 S5125 Attendant care services; per 15 minutes $191.39M
15 A0100 Non-emergency transportation; taxi $188.08M
16 G9006 Coordinated care fee, home monitoring $161.64M
17 H2015 Comprehensive community support services, per 15 minutes $146.57M
18 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 $146.42M
19 S5145 Foster care, therapeutic, child; per diem $134.91M
20 G0463 Hospital outpatient clinic visit for assessment and management of a patient $123.39M
21 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $108.33M
22 T1015 Clinic visit/encounter, all-inclusive $107.51M
23 90999 Unlisted dialysis procedure, inpatient or outpatient $104.24M
24 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $104.08M
25 Q3014 Telehealth originating site facility fee $97.83M
26 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $95.11M
27 T2022 Case management, per month $92.62M
28 T2021 Day habilitation, waiver; per 15 minutes $85.17M
29 T2023 Targeted case management; per month $81.85M
30 D0999 Unspecified diagnostic procedure, by report $81.21M
31 90834 Psychotherapy, 45 minutes with patient $81.11M
32 74177 Computed tomography, abdomen and pelvis; with contrast material $78.86M
33 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $78.41M
34 97530 Therapeutic activities, direct patient contact, each 15 minutes $73.58M
35 G9001 Coordinated care fee, initial rate $72.67M
36 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $66.05M
37 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) $62.08M
38 G0153 Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes $61.47M
39 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $58.26M
40 T2025 Waiver services; not otherwise specified (nos) $54.49M
41 D1120 Prophylaxis - child $52.15M
42 A0435 Fixed wing air mileage, per statute mile $50.90M
43 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $49.92M
44 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $48.32M
45 H0039 Assertive community treatment, face-to-face, per 15 minutes $48.10M
46 H2019 Therapeutic behavioral services, per 15 minutes $47.68M
47 99215 Prolong outpt/office vis $46.64M
48 90832 Psychotherapy, 30 minutes with patient $46.03M
49 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $45.95M
50 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $45.81M
51 70450 Computed tomography, head or brain; without contrast material $44.77M
52 T2031 Assisted living; waiver, per diem $42.70M
53 92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder $40.76M
54 D0150 Comprehensive oral evaluation - new or established patient $39.11M
55 S0201 Partial hospitalization services, less than 24 hours, per diem $38.88M
56 G0151 Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes $37.88M
57 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $37.64M
58 D2930 Prefabricated stainless steel crown - primary tooth $36.95M
59 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $36.74M
60 90853 Group psychotherapy (other than of a multiple-family group) $36.60M
61 99233 Prolong inpt eval add15 m $36.51M
62 G0378 Hospital observation service, per hour $35.55M
63 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $35.53M
64 99232 Subsequent hospital care, per day, moderate complexity $34.68M
65 H2033 Multisystemic therapy for juveniles, per 15 minutes $34.36M
66 H2017 Psychosocial rehabilitation services, per 15 minutes $34.21M
67 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report $33.93M
68 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $31.93M
69 H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem $31.45M
70 T1000 Private duty / independent nursing service(s) - licensed, up to 15 minutes $31.28M
71 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $30.37M
72 D1208 Topical application of fluoride, excluding varnish $29.59M
73 G0152 Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes $28.49M
74 T2001 Non-emergency transportation; patient attendant/escort $26.05M
75 J0178 Injection, aflibercept, 1 mg $25.88M
76 80053 Comprehensive metabolic panel $25.76M
77 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $25.47M
78 Q5003 Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf) $24.87M
79 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $24.23M
80 D0274 Bitewings - four radiographic images $24.05M
81 99282 Emergency department visit for the evaluation and management, low to moderate severity $23.58M
82 90791 Psychiatric diagnostic evaluation $23.54M
83 90847 Family psychotherapy with the patient present, 50 minutes $23.48M
84 87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B $23.42M
85 J0585 Injection, onabotulinumtoxina, 1 unit $23.42M
86 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $23.13M
87 Q5004 Hospice care provided in skilled nursing facility (snf) $22.98M
88 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $22.41M
89 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $22.34M
90 D0120 Periodic oral evaluation - established patient $22.12M
91 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 $21.62M
92 A0425 Ground mileage, per statute mile $21.58M
93 71045 Radiologic examination, chest; single view $21.25M
94 96375 Therapeutic injection; each additional sequential IV push $20.71M
95 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $20.38M
96 D2391 Resin-based composite - one surface, posterior, primary or permanent $20.23M
97 76820 $20.01M
98 74176 Computed tomography, abdomen and pelvis; without contrast material $19.98M
99 76819 Fetal biophysical profile; without non-stress testing $19.91M
100 H2000 Comprehensive multidisciplinary evaluation $19.02M
101 85025 Blood count; complete (CBC), automated, and automated differential WBC count $19.00M
102 90460 Immunization administration through 18 years of age via any route, first or only component $18.55M
103 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $18.39M
104 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $18.39M
105 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour $18.21M
106 T1017 Targeted case management, each 15 minutes $17.92M
107 D7140 Extraction, erupted tooth or exposed root $17.88M
108 A0436 Rotary wing air mileage, per statute mile $17.58M
109 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 $17.49M
110 D0220 Intraoral - periapical first radiographic image $16.52M
111 90461 $16.45M
112 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $16.06M
113 71046 Radiologic examination, chest; 2 views $15.93M
114 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis $15.80M
115 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $15.70M
116 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $15.67M
117 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 $15.63M
118 G9003 Coordinated care fee, risk adjusted high, initial $15.46M
119 88305 Level IV - Surgical pathology, gross and microscopic examination $15.24M
120 D1110 Prophylaxis - adult $15.07M
121 G0157 Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes $14.97M
122 G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes $14.87M
123 95004 Percutaneous tests with allergenic extracts, immediate type reaction $14.78M
124 96361 Intravenous infusion, hydration; each additional hour $14.76M
125 41899 Unlisted procedure, dentoalveolar structures $14.58M
126 S9122 Home health aide or certified nurse assistant, providing care in the home; per hour $14.16M
127 D7240 Removal of impacted tooth - completely bony $14.11M
128 T1002 Rn services, up to 15 minutes $14.01M
129 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $13.92M
130 D0272 Bitewings - two radiographic images $13.81M
131 77067 Screening mammography, bilateral, including computer-aided detection $13.71M
132 99223 Prolong inpt eval add15 m $13.59M
133 T2046 Hospice long term care, room and board only; per diem $13.56M
134 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $12.91M
135 96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular $12.88M
136 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $12.81M
137 G0158 Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes $12.80M
138 D0230 Intraoral - periapical each additional radiographic image $12.67M
139 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $12.60M
140 H0025 Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) $12.59M
141 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $12.52M
142 71275 Computed tomographic angiography, chest, with contrast material $12.47M
143 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation $11.97M
144 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $11.69M
145 S5165 Home modifications; per service $11.52M
146 87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism $11.34M
147 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $11.16M
148 84443 Thyroid stimulating hormone (TSH) $11.03M
149 T1005 Respite care services, up to 15 minutes $10.88M
150 D8080 Comprehensive orthodontic treatment of the adolescent dentition $10.76M
151 72125 Computed tomography, cervical spine; without contrast material $10.71M
152 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials $10.68M
153 G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit $10.66M
154 Q5001 Hospice or home health care provided in patient's home/residence $10.64M
155 D0140 Limited oral evaluation - problem focused $10.61M
156 V2020 Frames, purchases $10.37M
157 99442 $10.36M
158 0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel $10.24M
159 94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction $10.23M
160 D1351 Sealant - per tooth $10.06M
161 92340 Fitting of spectacles, except for aphakia; monofocal $9.98M
162 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $9.95M
163 45380 Colonoscopy, flexible; with biopsy, single or multiple $9.87M
164 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $9.80M
165 76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal $9.68M
166 E0601 Continuous positive airway pressure (cpap) device $9.62M
167 H2016 Comprehensive community support services, per diem $9.58M
168 36415 Collection of venous blood by venipuncture $9.57M
169 90792 Psychiatric diagnostic evaluation with medical services $9.47M
170 S9088 Services provided in an urgent care center (list in addition to code for service) $9.43M
171 T1007 Alcohol and/or substance abuse services, treatment plan development and/or modification $9.15M
172 76818 $8.91M
173 87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A $8.90M
174 A7030 Full face mask used with positive airway pressure device, each $8.84M
175 87631 $8.80M
176 D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction $8.78M
177 76801 $8.64M
178 87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets $8.51M
179 T1026 Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour $8.51M
180 71260 Computed tomography, thorax, diagnostic; with contrast material $8.37M
181 90846 Family psychotherapy without the patient present, 50 minutes $8.36M
182 70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences $8.21M
183 76705 Ultrasound, abdominal, real time with image documentation; limited $8.20M
184 87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) $8.19M
185 H0031 Mental health assessment, by non-physician $8.18M
186 80048 Basic metabolic panel (calcium, ionized) $8.17M
187 99441 $8.14M
188 90378 $8.14M
189 H0038 Self-help/peer services, per 15 minutes $8.10M
190 80050 General health panel $7.81M
191 E0431 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing $7.64M
192 99239 Hospital discharge day management, more than 30 minutes $7.63M
193 95810 Polysomnography; sleep staging with 4 or more additional parameters $7.60M
194 87633 Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets $7.60M
195 97150 Therapeutic procedure(s), group (2 or more individuals) $7.57M
196 80061 Lipid panel $7.50M
197 J0887 Injection, epoetin beta, 1 microgram, (for esrd on dialysis) $7.33M
198 96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance $7.30M
199 0002A $7.29M
200 0001A $7.29M