All 4,601 procedure codes billed by Medicaid providers in Texas, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | S5125 | Attendant care services; per 15 minutes | $15.92B |
| 2 | T1000 | Private duty / independent nursing service(s) - licensed, up to 15 minutes | $3.42B |
| 3 | H2016 | Comprehensive community support services, per diem | $2.39B |
| 4 | T1015 | Clinic visit/encounter, all-inclusive | $1.99B |
| 5 | 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) | $1.92B |
| 6 | 99284 | Emergency department visit for the evaluation and management, high severity | $1.50B |
| 7 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $1.41B |
| 8 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $1.18B |
| 9 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $903.82M |
| 10 | T2016 | Habilitation, residential, waiver; per diem | $879.82M |
| 11 | T2026 | Specialized childcare, waiver; per diem | $816.99M |
| 12 | H2014 | Skills training and development, per 15 minutes | $778.27M |
| 13 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $748.11M |
| 14 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $568.16M |
| 15 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $538.96M |
| 16 | T2046 | Hospice long term care, room and board only; per diem | $487.88M |
| 17 | T1005 | Respite care services, up to 15 minutes | $474.66M |
| 18 | S5101 | Day care services, adult; per half day | $445.01M |
| 19 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $426.66M |
| 20 | A0100 | Non-emergency transportation; taxi | $410.30M |
| 21 | S3620 | Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) | $370.55M |
| 22 | D0120 | Periodic oral evaluation - established patient | $299.45M |
| 23 | D0145 | Oral evaluation for a patient under three years of age | $297.94M |
| 24 | T1017 | Targeted case management, each 15 minutes | $297.91M |
| 25 | 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 | $294.77M |
| 26 | D1120 | Prophylaxis - child | $279.01M |
| 27 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $278.75M |
| 28 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $278.43M |
| 29 | D1351 | Sealant - per tooth | $262.24M |
| 30 | D2930 | Prefabricated stainless steel crown - primary tooth | $260.39M |
| 31 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $252.98M |
| 32 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $234.36M |
| 33 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $231.17M |
| 34 | T1027 | Family training and counseling for child development, per 15 minutes | $230.49M |
| 35 | H2017 | Psychosocial rehabilitation services, per 15 minutes | $229.74M |
| 36 | 90837 | Psychotherapy, 53 minutes with patient | $191.01M |
| 37 | 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 | $186.88M |
| 38 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $181.50M |
| 39 | D1110 | Prophylaxis - adult | $179.64M |
| 40 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $169.94M |
| 41 | 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 | $168.58M |
| 42 | T2017 | Habilitation, residential, waiver; 15 minutes | $165.74M |
| 43 | M0123 | $165.37M | |
| 44 | D0230 | Intraoral - periapical each additional radiographic image | $156.84M |
| 45 | S9124 | Nursing care, in the home; by licensed practical nurse, per hour | $155.31M |
| 46 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $148.27M |
| 47 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $146.28M |
| 48 | A0425 | Ground mileage, per statute mile | $142.03M |
| 49 | H2015 | Comprehensive community support services, per 15 minutes | $140.75M |
| 50 | 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | $136.90M |
| 51 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $130.44M |
| 52 | A4554 | Disposable underpads, all sizes | $129.68M |
| 53 | D1208 | Topical application of fluoride, excluding varnish | $127.12M |
| 54 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $126.86M |
| 55 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $121.90M |
| 56 | H2032 | Activity therapy, per 15 minutes | $119.09M |
| 57 | B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | $117.54M |
| 58 | D0274 | Bitewings - four radiographic images | $113.46M |
| 59 | M0150 | $112.45M | |
| 60 | T2020 | Day habilitation, waiver; per diem | $111.71M |
| 61 | D0220 | Intraoral - periapical first radiographic image | $111.19M |
| 62 | T2040 | Financial management, self-directed, waiver; per 15 minutes | $105.96M |
| 63 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $102.86M |
| 64 | D0272 | Bitewings - two radiographic images | $99.45M |
| 65 | S9110 | Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month | $95.22M |
| 66 | 97124 | $94.49M | |
| 67 | T2031 | Assisted living; waiver, per diem | $91.77M |
| 68 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $91.29M |
| 69 | 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | $89.51M |
| 70 | T2003 | Non-emergency transportation; encounter/trip | $88.30M |
| 71 | 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | $86.39M |
| 72 | 99232 | Subsequent hospital care, per day, moderate complexity | $86.34M |
| 73 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $86.09M |
| 74 | 99233 | Prolong inpt eval add15 m | $84.75M |
| 75 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $83.00M |
| 76 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $82.60M |
| 77 | T2022 | Case management, per month | $81.88M |
| 78 | 99469 | Subsequent inpatient neonatal critical care, per day, 28 days or younger | $81.67M |
| 79 | M0122 | $79.70M | |
| 80 | 99215 | Prolong outpt/office vis | $78.26M |
| 81 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $75.95M |
| 82 | 41899 | Unlisted procedure, dentoalveolar structures | $74.02M |
| 83 | 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | $72.37M |
| 84 | D0999 | Unspecified diagnostic procedure, by report | $71.33M |
| 85 | 90834 | Psychotherapy, 45 minutes with patient | $70.90M |
| 86 | 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | $69.50M |
| 87 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $68.19M |
| 88 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $67.61M |
| 89 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $66.64M |
| 90 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $66.27M |
| 91 | D0150 | Comprehensive oral evaluation - new or established patient | $65.07M |
| 92 | 80053 | Comprehensive metabolic panel | $62.05M |
| 93 | B9998 | Noc for enteral supplies | $61.95M |
| 94 | M0355 | $61.86M | |
| 95 | M0116 | $60.18M | |
| 96 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $57.84M |
| 97 | E0748 | Osteogenesis stimulator, electrical, non-invasive, spinal applications | $57.68M |
| 98 | D7240 | Removal of impacted tooth - completely bony | $56.36M |
| 99 | S9125 | Respite care, in the home, per diem | $56.24M |
| 100 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $56.18M |
| 101 | 01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | $55.88M |
| 102 | M0125 | $55.11M | |
| 103 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $54.77M |
| 104 | 81420 | Fetal chromosomal aneuploidy genomic sequence analysis panel | $54.18M |
| 105 | E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | $53.47M |
| 106 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $53.17M |
| 107 | M0152 | $52.40M | |
| 108 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $51.94M |
| 109 | 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | $51.48M |
| 110 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $51.38M |
| 111 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $51.21M |
| 112 | 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | $50.51M |
| 113 | K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | $50.46M |
| 114 | H2019 | Therapeutic behavioral services, per 15 minutes | $50.37M |
| 115 | D0210 | Intraoral - complete series of radiographic images | $50.30M |
| 116 | 71045 | Radiologic examination, chest; single view | $50.28M |
| 117 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $49.88M |
| 118 | 87428 | $45.85M | |
| 119 | E1399 | Durable medical equipment, miscellaneous | $45.60M |
| 120 | 99238 | Hospital discharge day management, 30 minutes or less | $45.58M |
| 121 | 99244 | Office or other outpatient consultation, moderate to high complexity | $45.57M |
| 122 | 93303 | Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study | $45.35M |
| 123 | S5165 | Home modifications; per service | $45.05M |
| 124 | 76819 | Fetal biophysical profile; without non-stress testing | $45.04M |
| 125 | 80050 | General health panel | $44.90M |
| 126 | A4353 | Intermittent urinary catheter, with insertion supplies | $44.59M |
| 127 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $44.48M |
| 128 | 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | $43.82M |
| 129 | 90791 | Psychiatric diagnostic evaluation | $43.66M |
| 130 | 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $43.25M |
| 131 | D1206 | Topical application of fluoride varnish | $42.94M |
| 132 | 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | $42.60M |
| 133 | 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | $42.11M |
| 134 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $41.61M |
| 135 | T1002 | Rn services, up to 15 minutes | $41.04M |
| 136 | 99479 | Subsequent intensive care, per day, very low birth weight infant | $40.82M |
| 137 | 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | $40.64M |
| 138 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $40.45M |
| 139 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $40.13M |
| 140 | S0621 | Routine ophthalmological examination including refraction; established patient | $39.97M |
| 141 | 99480 | Subsequent intensive care, per day, low birth weight infant | $39.90M |
| 142 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $39.52M |
| 143 | A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | $39.36M |
| 144 | 99460 | $39.23M | |
| 145 | T1013 | Sign language or oral interpretive services, per 15 minutes | $38.52M |
| 146 | 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 | $38.45M |
| 147 | 99223 | Prolong inpt eval add15 m | $38.22M |
| 148 | 70450 | Computed tomography, head or brain; without contrast material | $37.34M |
| 149 | M0167 | $37.24M | |
| 150 | 92526 | $36.86M | |
| 151 | 00170 | Anesthesia for intraoral procedures, including biopsy | $36.66M |
| 152 | D9248 | $36.48M | |
| 153 | V2020 | Frames, purchases | $36.27M |
| 154 | E2402 | Negative pressure wound therapy electrical pump, stationary or portable | $36.02M |
| 155 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $35.85M |
| 156 | 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | $35.71M |
| 157 | 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | $35.68M |
| 158 | 99381 | $35.66M | |
| 159 | G0226 | $35.34M | |
| 160 | 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 | $35.26M |
| 161 | G0749 | $34.95M | |
| 162 | A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | $34.31M |
| 163 | T4532 | Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each | $34.29M |
| 164 | D3220 | Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction | $34.00M |
| 165 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $33.99M |
| 166 | G0378 | Hospital observation service, per hour | $33.95M |
| 167 | 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 | $33.18M |
| 168 | G0176 | Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more) | $33.14M |
| 169 | T2042 | Hospice routine home care; per diem | $32.81M |
| 170 | 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 | $32.25M |
| 171 | 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | $32.17M |
| 172 | 99472 | Subsequent inpatient pediatric critical care, per day, 2-5 years | $31.95M |
| 173 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $31.46M |
| 174 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $30.91M |
| 175 | 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | $30.55M |
| 176 | 80061 | Lipid panel | $30.16M |
| 177 | G0100 | $30.10M | |
| 178 | 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $30.07M |
| 179 | 90832 | Psychotherapy, 30 minutes with patient | $29.96M |
| 180 | 87631 | $29.14M | |
| 181 | 95715 | $29.09M | |
| 182 | B4153 | Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | $28.91M |
| 183 | 96131 | $28.87M | |
| 184 | V2025 | Deluxe frame | $28.82M |
| 185 | S0620 | Routine ophthalmological examination including refraction; new patient | $28.74M |
| 186 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $28.74M |
| 187 | G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | $28.52M |
| 188 | 96110 | Developmental screening, with scoring and documentation, per standardized instrument | $28.01M |
| 189 | E0570 | Nebulizer, with compressor | $27.97M |
| 190 | T4544 | Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each | $27.70M |
| 191 | A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | $27.69M |
| 192 | 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | $27.58M |
| 193 | H2011 | Crisis intervention service, per 15 minutes | $27.34M |
| 194 | J2326 | Injection, nusinersen, 0.1 mg | $27.32M |
| 195 | 59514 | $27.27M | |
| 196 | A4335 | Incontinence supply; miscellaneous | $27.19M |
| 197 | D0330 | Panoramic radiographic image | $26.96M |
| 198 | 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | $26.63M |
| 199 | E0603 | Breast pump, electric (ac and/or dc), any type | $26.58M |
| 200 | 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | $26.53M |