All 1,486 procedure codes billed by Medicaid providers in South Dakota, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | T2016 | Habilitation, residential, waiver; per diem | $662.65M |
| 2 | T2048 | Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem | $185.72M |
| 3 | T2020 | Day habilitation, waiver; per diem | $177.59M |
| 4 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $175.77M |
| 5 | S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | $62.72M |
| 6 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $57.88M |
| 7 | T2031 | Assisted living; waiver, per diem | $46.10M |
| 8 | H2016 | Comprehensive community support services, per diem | $39.55M |
| 9 | H2021 | Community-based wrap-around services, per 15 minutes | $38.94M |
| 10 | T2025 | Waiver services; not otherwise specified (nos) | $35.34M |
| 11 | S5125 | Attendant care services; per 15 minutes | $32.79M |
| 12 | 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) | $29.50M |
| 13 | S5130 | Homemaker service, nos; per 15 minutes | $29.16M |
| 14 | 90837 | Psychotherapy, 53 minutes with patient | $28.49M |
| 15 | T1016 | Case management, each 15 minutes | $26.91M |
| 16 | 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) | $26.79M |
| 17 | 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 | $26.28M |
| 18 | J3490 | Unclassified drugs | $23.32M |
| 19 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $20.00M |
| 20 | T1000 | Private duty / independent nursing service(s) - licensed, up to 15 minutes | $17.58M |
| 21 | H0039 | Assertive community treatment, face-to-face, per 15 minutes | $16.25M |
| 22 | A0430 | Ambulance service, conventional air services, transport, one way (fixed wing) | $15.32M |
| 23 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $15.10M |
| 24 | D2930 | Prefabricated stainless steel crown - primary tooth | $14.17M |
| 25 | A0435 | Fixed wing air mileage, per statute mile | $13.35M |
| 26 | 90832 | Psychotherapy, 30 minutes with patient | $12.73M |
| 27 | 99284 | Emergency department visit for the evaluation and management, high severity | $12.34M |
| 28 | 99232 | Subsequent hospital care, per day, moderate complexity | $11.90M |
| 29 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $11.35M |
| 30 | S5135 | Companion care, adult (e.g., iadl/adl); per 15 minutes | $10.89M |
| 31 | S9124 | Nursing care, in the home; by licensed practical nurse, per hour | $10.42M |
| 32 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $10.29M |
| 33 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $10.14M |
| 34 | 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) | $9.81M |
| 35 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $9.76M |
| 36 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $9.63M |
| 37 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $9.48M |
| 38 | V2020 | Frames, purchases | $9.02M |
| 39 | D0120 | Periodic oral evaluation - established patient | $8.94M |
| 40 | 36415 | Collection of venous blood by venipuncture | $8.70M |
| 41 | D1120 | Prophylaxis - child | $8.41M |
| 42 | W0037 | $8.21M | |
| 43 | D1206 | Topical application of fluoride varnish | $8.11M |
| 44 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $7.63M |
| 45 | V2199 | Not otherwise classified, single vision lens | $7.38M |
| 46 | T2018 | Habilitation, supported employment, waiver; per diem | $7.38M |
| 47 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $7.25M |
| 48 | 90378 | $7.18M | |
| 49 | 99215 | Prolong outpt/office vis | $7.03M |
| 50 | T2014 | Habilitation, prevocational, waiver; per diem | $6.97M |
| 51 | D7140 | Extraction, erupted tooth or exposed root | $6.67M |
| 52 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $6.64M |
| 53 | 90863 | $6.60M | |
| 54 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $6.56M |
| 55 | T2033 | Residential care, not otherwise specified (nos), waiver; per diem | $6.54M |
| 56 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $6.38M |
| 57 | 99233 | Prolong inpt eval add15 m | $6.22M |
| 58 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $6.11M |
| 59 | A0425 | Ground mileage, per statute mile | $6.05M |
| 60 | D1110 | Prophylaxis - adult | $5.94M |
| 61 | D1351 | Sealant - per tooth | $5.86M |
| 62 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $5.64M |
| 63 | T2028 | Specialized supply, not otherwise specified, waiver | $5.60M |
| 64 | 00170 | Anesthesia for intraoral procedures, including biopsy | $5.47M |
| 65 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $5.42M |
| 66 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $5.28M |
| 67 | D0140 | Limited oral evaluation - problem focused | $5.25M |
| 68 | A0130 | Non-emergency transportation: wheelchair van | $5.23M |
| 69 | 99223 | Prolong inpt eval add15 m | $5.03M |
| 70 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $4.96M |
| 71 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $4.92M |
| 72 | T2017 | Habilitation, residential, waiver; 15 minutes | $4.82M |
| 73 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $4.66M |
| 74 | 59400 | Routine obstetric care including antepartum care, vaginal delivery, and postpartum care | $4.64M |
| 75 | 90834 | Psychotherapy, 45 minutes with patient | $4.42M |
| 76 | T2019 | Habilitation, supported employment, waiver; per 15 minutes | $4.33M |
| 77 | 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 | $4.31M |
| 78 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $4.25M |
| 79 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $4.12M |
| 80 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $3.91M |
| 81 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $3.79M |
| 82 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $3.78M |
| 83 | S0209 | Wheelchair van, mileage, per mile | $3.72M |
| 84 | T1005 | Respite care services, up to 15 minutes | $3.64M |
| 85 | 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 | $3.60M |
| 86 | 41899 | Unlisted procedure, dentoalveolar structures | $3.52M |
| 87 | 90791 | Psychiatric diagnostic evaluation | $3.50M |
| 88 | 99469 | Subsequent inpatient neonatal critical care, per day, 28 days or younger | $3.36M |
| 89 | D0150 | Comprehensive oral evaluation - new or established patient | $3.34M |
| 90 | 90853 | Group psychotherapy (other than of a multiple-family group) | $3.25M |
| 91 | A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | $3.20M |
| 92 | 99480 | Subsequent intensive care, per day, low birth weight infant | $3.16M |
| 93 | D7240 | Removal of impacted tooth - completely bony | $3.01M |
| 94 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $2.96M |
| 95 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $2.77M |
| 96 | 0001A | $2.76M | |
| 97 | 99239 | Hospital discharge day management, more than 30 minutes | $2.74M |
| 98 | S0215 | Non-emergency transportation; mileage, per mile | $2.72M |
| 99 | 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | $2.71M |
| 100 | 99222 | Initial hospital care, per day, moderate complexity | $2.66M |
| 101 | D0220 | Intraoral - periapical first radiographic image | $2.66M |
| 102 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $2.66M |
| 103 | 0002A | $2.65M | |
| 104 | H0005 | Alcohol and/or drug services; group counseling by a clinician | $2.56M |
| 105 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $2.51M |
| 106 | D0272 | Bitewings - two radiographic images | $2.40M |
| 107 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $2.39M |
| 108 | D0210 | Intraoral - complete series of radiographic images | $2.28M |
| 109 | 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | $2.28M |
| 110 | 92015 | Determination of refractive state | $2.26M |
| 111 | 80053 | Comprehensive metabolic panel | $2.23M |
| 112 | D9420 | $2.22M | |
| 113 | 99238 | Hospital discharge day management, 30 minutes or less | $2.21M |
| 114 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $2.21M |
| 115 | A9270 | Non-covered item or service | $2.17M |
| 116 | 90792 | Psychiatric diagnostic evaluation with medical services | $2.16M |
| 117 | S5170 | Home delivered meals, including preparation; per meal | $2.15M |
| 118 | D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | $2.08M |
| 119 | 90472 | Immunization administration, each additional vaccine (list separately) | $2.05M |
| 120 | D0274 | Bitewings - four radiographic images | $2.02M |
| 121 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $1.96M |
| 122 | T1002 | Rn services, up to 15 minutes | $1.96M |
| 123 | 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $1.85M |
| 124 | D1208 | Topical application of fluoride, excluding varnish | $1.81M |
| 125 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $1.81M |
| 126 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $1.81M |
| 127 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $1.80M |
| 128 | A9900 | Miscellaneous dme supply, accessory, and/or service component of another hcpcs code | $1.72M |
| 129 | D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | $1.68M |
| 130 | D9222 | $1.64M | |
| 131 | 70450 | Computed tomography, head or brain; without contrast material | $1.64M |
| 132 | H2012 | Behavioral health day treatment, per hour | $1.62M |
| 133 | J0585 | Injection, onabotulinumtoxina, 1 unit | $1.61M |
| 134 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $1.54M |
| 135 | M0799 | $1.54M | |
| 136 | 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | $1.52M |
| 137 | A0436 | Rotary wing air mileage, per statute mile | $1.51M |
| 138 | 0071A | $1.50M | |
| 139 | 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | $1.49M |
| 140 | 0072A | $1.43M | |
| 141 | 92526 | $1.42M | |
| 142 | 99205 | Prolong outpt/office vis | $1.42M |
| 143 | 0202U | Oncology (prostate), multianalyte, gene expression profiling | $1.42M |
| 144 | 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | $1.39M |
| 145 | 99479 | Subsequent intensive care, per day, very low birth weight infant | $1.38M |
| 146 | B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | $1.36M |
| 147 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $1.34M |
| 148 | 71046 | Radiologic examination, chest; 2 views | $1.31M |
| 149 | 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $1.30M |
| 150 | 99472 | Subsequent inpatient pediatric critical care, per day, 2-5 years | $1.28M |
| 151 | 97139 | $1.26M | |
| 152 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $1.24M |
| 153 | A4335 | Incontinence supply; miscellaneous | $1.24M |
| 154 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $1.22M |
| 155 | 71275 | Computed tomographic angiography, chest, with contrast material | $1.20M |
| 156 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $1.20M |
| 157 | V2784 | Lens, polycarbonate or equal, any index, per lens | $1.20M |
| 158 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $1.20M |
| 159 | 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | $1.17M |
| 160 | Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | $1.17M |
| 161 | 76819 | Fetal biophysical profile; without non-stress testing | $1.16M |
| 162 | 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 | $1.15M |
| 163 | 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | $1.14M |
| 164 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $1.14M |
| 165 | 97155 | Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes | $1.14M |
| 166 | 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | $1.13M |
| 167 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $1.12M |
| 168 | 99308 | Subsequent nursing facility care, per day, straightforward | $1.10M |
| 169 | 99231 | Subsequent hospital care, per day, straightforward or low complexity | $1.10M |
| 170 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $1.09M |
| 171 | 99460 | $1.08M | |
| 172 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $1.05M |
| 173 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $1.04M |
| 174 | D0230 | Intraoral - periapical each additional radiographic image | $1.01M |
| 175 | D2140 | $1.00M | |
| 176 | 90961 | $989K | |
| 177 | T1012 | Alcohol and/or substance abuse services, skills development | $983K |
| 178 | 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | $970K |
| 179 | 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | $966K |
| 180 | S5161 | Emergency response system; service fee, per month (excludes installation and testing) | $962K |
| 181 | S9977 | Meals, per diem, not otherwise specified | $952K |
| 182 | 00731 | $949K | |
| 183 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $943K |
| 184 | 90686 | $917K | |
| 185 | D2330 | $917K | |
| 186 | H2036 | Alcohol and/or other drug treatment program, per diem | $917K |
| 187 | D2150 | Silver amalgam - two surfaces, primary or permanent | $915K |
| 188 | 71045 | Radiologic examination, chest; single view | $892K |
| 189 | 0240U | $891K | |
| 190 | D2390 | $842K | |
| 191 | 43235 | $825K | |
| 192 | 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | $822K |
| 193 | J7120 | Ringers lactate infusion, up to 1000 cc | $803K |
| 194 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $800K |
| 195 | 99254 | $798K | |
| 196 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $792K |
| 197 | 0054A | $787K | |
| 198 | 97799 | $768K | |
| 199 | 84443 | Thyroid stimulating hormone (TSH) | $734K |
| 200 | H0001 | Alcohol and/or drug assessment | $723K |