Medicaid Provider Spending

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

Billing Codes in Oregon

All 2,831 procedure codes billed by Medicaid providers in Oregon, ranked by total spending.

#CodeDescriptionTotal Paid
1 90837 Psychotherapy, 53 minutes with patient $500.73M
2 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $469.57M
3 99284 Emergency department visit for the evaluation and management, high severity $405.25M
4 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $376.33M
5 99283 Emergency department visit for the evaluation and management, moderate severity $312.79M
6 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $299.80M
7 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) $282.90M
8 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 $276.31M
9 H0004 Behavioral health counseling and therapy, per 15 minutes $180.46M
10 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $176.76M
11 H0005 Alcohol and/or drug services; group counseling by a clinician $144.23M
12 H0010 Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) $117.22M
13 A0100 Non-emergency transportation; taxi $85.79M
14 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $77.70M
15 H0017 Behavioral health; residential (hospital residential treatment program), without room and board, per diem $72.93M
16 H0011 Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) $72.14M
17 97530 Therapeutic activities, direct patient contact, each 15 minutes $71.80M
18 G0463 Hospital outpatient clinic visit for assessment and management of a patient $67.37M
19 T1017 Targeted case management, each 15 minutes $62.28M
20 90834 Psychotherapy, 45 minutes with patient $61.36M
21 H0038 Self-help/peer services, per 15 minutes $60.92M
22 H2013 Psychiatric health facility service, per diem $53.47M
23 S9484 Crisis intervention mental health services, per hour $49.89M
24 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $49.63M
25 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $45.01M
26 J7170 Injection, emicizumab-kxwh, 0.5 mg $44.35M
27 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $41.26M
28 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) $40.07M
29 99215 Prolong outpt/office vis $39.74M
30 90999 Unlisted dialysis procedure, inpatient or outpatient $39.50M
31 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $38.67M
32 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $37.66M
33 H2014 Skills training and development, per 15 minutes $37.16M
34 T1002 Rn services, up to 15 minutes $36.62M
35 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $36.43M
36 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $34.75M
37 H0048 Alcohol and/or other drug testing: collection and handling only, specimens other than blood $33.23M
38 A0130 Non-emergency transportation: wheelchair van $32.58M
39 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $30.46M
40 H0037 Community psychiatric supportive treatment program, per diem $29.56M
41 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $29.13M
42 H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem $28.34M
43 97124 $28.00M
44 99282 Emergency department visit for the evaluation and management, low to moderate severity $27.49M
45 S0109 Methadone, oral, 5 mg $27.07M
46 D1120 Prophylaxis - child $26.62M
47 98941 Chiropractic manipulative treatment; spinal, 3-4 regions $26.22M
48 T1016 Case management, each 15 minutes $26.03M
49 H2018 Psychosocial rehabilitation services, per diem $25.78M
50 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $25.63M
51 90832 Psychotherapy, 30 minutes with patient $25.50M
52 74177 Computed tomography, abdomen and pelvis; with contrast material $25.46M
53 88305 Level IV - Surgical pathology, gross and microscopic examination $25.34M
54 D0120 Periodic oral evaluation - established patient $24.88M
55 S5125 Attendant care services; per 15 minutes $24.77M
56 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $23.83M
57 E0601 Continuous positive airway pressure (cpap) device $23.60M
58 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 $23.09M
59 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $22.93M
60 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $22.89M
61 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 $22.82M
62 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $21.52M
63 J0178 Injection, aflibercept, 1 mg $21.29M
64 D2930 Prefabricated stainless steel crown - primary tooth $21.28M
65 D0140 Limited oral evaluation - problem focused $21.03M
66 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $20.28M
67 80053 Comprehensive metabolic panel $19.94M
68 90847 Family psychotherapy with the patient present, 50 minutes $19.88M
69 S9480 Intensive outpatient psychiatric services, per diem $19.75M
70 H0046 Mental health services, not otherwise specified $19.65M
71 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 $19.50M
72 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $18.54M
73 T1015 Clinic visit/encounter, all-inclusive $18.04M
74 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) $18.02M
75 A0434 Specialty care transport (sct) $17.87M
76 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $17.79M
77 99233 Prolong inpt eval add15 m $17.04M
78 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $16.99M
79 A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips $16.50M
80 A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply $16.45M
81 D1206 Topical application of fluoride varnish $16.32M
82 T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each $16.30M
83 D7140 Extraction, erupted tooth or exposed root $16.25M
84 90853 Group psychotherapy (other than of a multiple-family group) $15.90M
85 D1110 Prophylaxis - adult $15.40M
86 90791 Psychiatric diagnostic evaluation $15.39M
87 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $15.11M
88 A0436 Rotary wing air mileage, per statute mile $14.83M
89 A7030 Full face mask used with positive airway pressure device, each $14.65M
90 D0150 Comprehensive oral evaluation - new or established patient $14.52M
91 T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each $14.38M
92 92340 Fitting of spectacles, except for aphakia; monofocal $14.38M
93 99232 Subsequent hospital care, per day, moderate complexity $14.23M
94 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 $14.19M
95 A0425 Ground mileage, per statute mile $14.08M
96 T4535 Disposable liner/shield/guard/pad/undergarment, for incontinence, each $13.90M
97 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $13.66M
98 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $13.63M
99 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $13.40M
100 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $13.39M
101 85025 Blood count; complete (CBC), automated, and automated differential WBC count $13.08M
102 T4528 Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each $12.60M
103 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) $12.38M
104 H2036 Alcohol and/or other drug treatment program, per diem $12.28M
105 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $12.25M
106 45380 Colonoscopy, flexible; with biopsy, single or multiple $12.15M
107 77067 Screening mammography, bilateral, including computer-aided detection $12.00M
108 T1018 School-based individualized education program (iep) services, bundled $11.68M
109 S4993 Contraceptive pills for birth control $11.62M
110 H0033 Oral medication administration, direct observation $11.47M
111 LF001 $11.33M
112 H0045 Respite care services, not in the home, per diem $11.16M
113 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $11.00M
114 E0603 Breast pump, electric (ac and/or dc), any type $10.85M
115 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $10.78M
116 71046 Radiologic examination, chest; 2 views $10.56M
117 A4927 Gloves, non-sterile, per 100 $10.40M
118 A0090 Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest $10.36M
119 84443 Thyroid stimulating hormone (TSH) $10.24M
120 G9006 Coordinated care fee, home monitoring $10.04M
121 A7034 Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap $9.90M
122 H0032 Mental health service plan development by non-physician $9.83M
123 71045 Radiologic examination, chest; single view $9.78M
124 A7031 Face mask interface, replacement for full face mask, each $9.48M
125 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $9.37M
126 A4604 Tubing with integrated heating element for use with positive airway pressure device $8.99M
127 A0120 Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems $8.92M
128 70450 Computed tomography, head or brain; without contrast material $8.87M
129 J0585 Injection, onabotulinumtoxina, 1 unit $8.77M
130 80061 Lipid panel $8.69M
131 99205 Prolong outpt/office vis $8.53M
132 D0220 Intraoral - periapical first radiographic image $8.50M
133 41899 Unlisted procedure, dentoalveolar structures $8.34M
134 36415 Collection of venous blood by venipuncture $8.31M
135 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $7.99M
136 97810 $7.95M
137 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $7.91M
138 90686 $7.90M
139 V2020 Frames, purchases $7.88M
140 96375 Therapeutic injection; each additional sequential IV push $7.86M
141 D2391 Resin-based composite - one surface, posterior, primary or permanent $7.78M
142 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 $7.76M
143 A4239 Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service $7.60M
144 E2402 Negative pressure wound therapy electrical pump, stationary or portable $7.48M
145 E0562 Humidifier, heated, used with positive airway pressure device $7.39M
146 S5161 Emergency response system; service fee, per month (excludes installation and testing) $7.35M
147 T1040 Medicaid certified community behavioral health clinic services, per diem $7.30M
148 T2046 Hospice long term care, room and board only; per diem $7.21M
149 D0230 Intraoral - periapical each additional radiographic image $7.04M
150 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $7.00M
151 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $6.96M
152 99223 Prolong inpt eval add15 m $6.89M
153 93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only $6.87M
154 H0001 Alcohol and/or drug assessment $6.86M
155 A7032 Cushion for use on nasal mask interface, replacement only, each $6.85M
156 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis $6.85M
157 H2022 Community-based wrap-around services, per diem $6.84M
158 80050 General health panel $6.84M
159 83036 Hemoglobin; glycosylated (A1C) $6.82M
160 E0470 Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) $6.82M
161 T4541 Incontinence product, disposable underpad, large, each $6.71M
162 H0035 Mental health partial hospitalization, treatment, less than 24 hours $6.70M
163 Q9992 Injection, buprenorphine extended-release (sublocade), greater than 100 mg $6.67M
164 67028 Intravitreal injection of a pharmacologic agent $6.66M
165 D1351 Sealant - per tooth $6.62M
166 A0435 Fixed wing air mileage, per statute mile $6.57M
167 97811 $6.57M
168 E0466 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) $6.42M
169 E0465 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) $6.41M
170 D0274 Bitewings - four radiographic images $6.39M
171 H0031 Mental health assessment, by non-physician $6.33M
172 11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm $6.27M
173 90792 Psychiatric diagnostic evaluation with medical services $6.27M
174 H0016 Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) $6.17M
175 99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward $6.00M
176 92015 Determination of refractive state $5.99M
177 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 $5.95M
178 A9277 Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system $5.95M
179 87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies $5.79M
180 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 $5.75M
181 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report $5.74M
182 T4523 Adult sized disposable incontinence product, brief/diaper, large, each $5.66M
183 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $5.62M
184 T4534 Youth sized disposable incontinence product, protective underwear/pull-on, each $5.62M
185 96361 Intravenous infusion, hydration; each additional hour $5.58M
186 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $5.56M
187 95810 Polysomnography; sleep staging with 4 or more additional parameters $5.40M
188 T2034 Crisis intervention, waiver; per diem $5.33M
189 SRX01 $5.16M
190 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $5.16M
191 96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance $5.09M
192 99601 $5.09M
193 J7192 Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified $5.04M
194 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 $4.93M
195 D1208 Topical application of fluoride, excluding varnish $4.86M
196 H0006 Alcohol and/or drug services; case management $4.86M
197 E0784 External ambulatory infusion pump, insulin $4.82M
198 95811 $4.75M
199 H0012 Alcohol and/or drug services; sub-acute detoxification (residential addiction program outpatient) $4.73M
200 99499 $4.69M