All 3,943 procedure codes billed by Medicaid providers in Virginia, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | 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) | $4.18B |
| 2 | H2022 | Community-based wrap-around services, per diem | $2.09B |
| 3 | H0046 | Mental health services, not otherwise specified | $1.42B |
| 4 | T2033 | Residential care, not otherwise specified (nos), waiver; per diem | $1.19B |
| 5 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $988.13M |
| 6 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $801.31M |
| 7 | H0023 | Behavioral health outreach service (planned approach to reach a targeted population) | $747.84M |
| 8 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $668.49M |
| 9 | H2012 | Behavioral health day treatment, per hour | $648.53M |
| 10 | 99284 | Emergency department visit for the evaluation and management, high severity | $627.66M |
| 11 | H2014 | Skills training and development, per 15 minutes | $510.44M |
| 12 | 97150 | Therapeutic procedure(s), group (2 or more individuals) | $488.59M |
| 13 | T1005 | Respite care services, up to 15 minutes | $480.27M |
| 14 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $446.87M |
| 15 | T1017 | Targeted case management, each 15 minutes | $431.61M |
| 16 | S9124 | Nursing care, in the home; by licensed practical nurse, per hour | $399.16M |
| 17 | T2003 | Non-emergency transportation; encounter/trip | $373.74M |
| 18 | 90837 | Psychotherapy, 53 minutes with patient | $327.76M |
| 19 | S9482 | Family stabilization services, per 15 minutes | $311.27M |
| 20 | H2033 | Multisystemic therapy for juveniles, per 15 minutes | $294.13M |
| 21 | 96361 | Intravenous infusion, hydration; each additional hour | $288.41M |
| 22 | H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | $287.05M |
| 23 | H0035 | Mental health partial hospitalization, treatment, less than 24 hours | $279.14M |
| 24 | H2011 | Crisis intervention service, per 15 minutes | $239.64M |
| 25 | S0201 | Partial hospitalization services, less than 24 hours, per diem | $238.81M |
| 26 | H2019 | Therapeutic behavioral services, per 15 minutes | $203.12M |
| 27 | S5121 | Chore services; per diem | $200.83M |
| 28 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $197.02M |
| 29 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $194.26M |
| 30 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $184.62M |
| 31 | G9012 | Other specified case management service not elsewhere classified | $180.00M |
| 32 | H2017 | Psychosocial rehabilitation services, per 15 minutes | $179.63M |
| 33 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $165.45M |
| 34 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $163.34M |
| 35 | T2021 | Day habilitation, waiver; per 15 minutes | $144.29M |
| 36 | 97153 | Adaptive behavior treatment by protocol, administered by technician, each 15 minutes | $143.31M |
| 37 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $142.37M |
| 38 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $141.44M |
| 39 | T1003 | Lpn/lvn services, up to 15 minutes | $140.27M |
| 40 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $138.78M |
| 41 | 70450 | Computed tomography, head or brain; without contrast material | $114.26M |
| 42 | 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 | $113.66M |
| 43 | A0130 | Non-emergency transportation: wheelchair van | $109.33M |
| 44 | H0040 | Assertive community treatment program, per diem | $101.29M |
| 45 | 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) | $89.06M |
| 46 | H2016 | Comprehensive community support services, per diem | $88.27M |
| 47 | S5102 | Day care services, adult; per diem | $86.98M |
| 48 | 97155 | Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes | $86.00M |
| 49 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $84.41M |
| 50 | T2005 | Non-emergency transportation; stretcher van | $81.38M |
| 51 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $81.19M |
| 52 | G0378 | Hospital observation service, per hour | $81.05M |
| 53 | S0109 | Methadone, oral, 5 mg | $80.71M |
| 54 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $77.58M |
| 55 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $74.52M |
| 56 | 90834 | Psychotherapy, 45 minutes with patient | $73.36M |
| 57 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $72.23M |
| 58 | D8670 | Periodic orthodontic treatment visit | $71.05M |
| 59 | A0100 | Non-emergency transportation; taxi | $71.04M |
| 60 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $69.13M |
| 61 | D1120 | Prophylaxis - child | $68.59M |
| 62 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $67.86M |
| 63 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $64.87M |
| 64 | 99232 | Subsequent hospital care, per day, moderate complexity | $64.53M |
| 65 | S0215 | Non-emergency transportation; mileage, per mile | $63.37M |
| 66 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $63.02M |
| 67 | 99215 | Prolong outpt/office vis | $62.90M |
| 68 | H0039 | Assertive community treatment, face-to-face, per 15 minutes | $62.51M |
| 69 | 97139 | $61.81M | |
| 70 | H2034 | Alcohol and/or drug abuse halfway house services, per diem | $61.36M |
| 71 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $60.74M |
| 72 | T2022 | Case management, per month | $60.65M |
| 73 | A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | $60.02M |
| 74 | 90935 | Hemodialysis procedure with single evaluation by a physician | $59.46M |
| 75 | H0043 | Supported housing, per diem | $58.14M |
| 76 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $55.65M |
| 77 | T2023 | Targeted case management; per month | $53.26M |
| 78 | 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 | $52.51M |
| 79 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $52.29M |
| 80 | D0120 | Periodic oral evaluation - established patient | $49.23M |
| 81 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $48.95M |
| 82 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $47.41M |
| 83 | D1110 | Prophylaxis - adult | $47.18M |
| 84 | G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | $46.32M |
| 85 | J9271 | Injection, pembrolizumab, 1 mg | $46.30M |
| 86 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $46.22M |
| 87 | 99233 | Prolong inpt eval add15 m | $45.62M |
| 88 | A0425 | Ground mileage, per statute mile | $45.51M |
| 89 | 41899 | Unlisted procedure, dentoalveolar structures | $44.93M |
| 90 | 71275 | Computed tomographic angiography, chest, with contrast material | $44.35M |
| 91 | 99509 | Home visit for assistance with activities of daily living and personal care | $42.29M |
| 92 | G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | $42.22M |
| 93 | 90791 | Psychiatric diagnostic evaluation | $41.70M |
| 94 | 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | $40.96M |
| 95 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $40.61M |
| 96 | 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | $39.55M |
| 97 | D1206 | Topical application of fluoride varnish | $39.49M |
| 98 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $38.63M |
| 99 | 92508 | Group treatment of speech, language, voice, communication, and/or auditory processing disorder | $37.93M |
| 100 | 90832 | Psychotherapy, 30 minutes with patient | $37.49M |
| 101 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $37.34M |
| 102 | Q5009 | Hospice or home health care provided in place not otherwise specified (nos) | $36.80M |
| 103 | H2018 | Psychosocial rehabilitation services, per diem | $36.37M |
| 104 | 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 | $35.85M |
| 105 | D7140 | Extraction, erupted tooth or exposed root | $35.49M |
| 106 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $34.94M |
| 107 | H2036 | Alcohol and/or other drug treatment program, per diem | $34.25M |
| 108 | D2930 | Prefabricated stainless steel crown - primary tooth | $33.80M |
| 109 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $33.06M |
| 110 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $32.85M |
| 111 | 99309 | Subsequent nursing facility care, per day, low to moderate complexity | $32.21M |
| 112 | G0153 | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes | $31.22M |
| 113 | S9083 | Global fee urgent care centers | $30.64M |
| 114 | 99223 | Prolong inpt eval add15 m | $29.80M |
| 115 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $29.41M |
| 116 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $28.29M |
| 117 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $28.06M |
| 118 | 59025 | Fetal non-stress test | $27.78M |
| 119 | 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | $27.57M |
| 120 | T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | $27.47M |
| 121 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $27.16M |
| 122 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $26.74M |
| 123 | H2020 | Therapeutic behavioral services, per diem | $26.61M |
| 124 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $26.40M |
| 125 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $25.81M |
| 126 | S9342 | Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem | $25.47M |
| 127 | 45380 | Colonoscopy, flexible; with biopsy, single or multiple | $25.08M |
| 128 | 90792 | Psychiatric diagnostic evaluation with medical services | $25.06M |
| 129 | E1399 | Durable medical equipment, miscellaneous | $25.06M |
| 130 | D0150 | Comprehensive oral evaluation - new or established patient | $24.96M |
| 131 | 99281 | Emergency department visit for the evaluation and management, self-limited or minor | $24.94M |
| 132 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $24.35M |
| 133 | D7240 | Removal of impacted tooth - completely bony | $23.51M |
| 134 | H0006 | Alcohol and/or drug services; case management | $23.23M |
| 135 | G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | $23.14M |
| 136 | 96110 | Developmental screening, with scoring and documentation, per standardized instrument | $22.96M |
| 137 | 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | $22.72M |
| 138 | 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | $22.64M |
| 139 | J0178 | Injection, aflibercept, 1 mg | $21.59M |
| 140 | 80053 | Comprehensive metabolic panel | $21.53M |
| 141 | 76705 | Ultrasound, abdominal, real time with image documentation; limited | $21.44M |
| 142 | 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | $21.10M |
| 143 | S9485 | Crisis intervention mental health services, per diem | $20.77M |
| 144 | H2023 | Supported employment, per 15 minutes | $20.57M |
| 145 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $20.51M |
| 146 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $20.35M |
| 147 | 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 | $20.35M |
| 148 | 71046 | Radiologic examination, chest; 2 views | $19.92M |
| 149 | 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | $19.90M |
| 150 | T1028 | Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs | $19.89M |
| 151 | H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | $19.68M |
| 152 | D1208 | Topical application of fluoride, excluding varnish | $19.54M |
| 153 | T1016 | Case management, each 15 minutes | $19.38M |
| 154 | 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | $19.30M |
| 155 | 97161 | $19.15M | |
| 156 | D1351 | Sealant - per tooth | $19.15M |
| 157 | A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | $19.03M |
| 158 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $18.95M |
| 159 | 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | $18.49M |
| 160 | 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | $18.43M |
| 161 | D8080 | Comprehensive orthodontic treatment of the adolescent dentition | $18.36M |
| 162 | J0585 | Injection, onabotulinumtoxina, 1 unit | $18.31M |
| 163 | 77067 | Screening mammography, bilateral, including computer-aided detection | $18.08M |
| 164 | 76830 | Ultrasound, transvaginal | $17.25M |
| 165 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $16.97M |
| 166 | Q5001 | Hospice or home health care provided in patient's home/residence | $16.93M |
| 167 | D0330 | Panoramic radiographic image | $16.75M |
| 168 | G2021 | Health care practitioners rendering treatment in place (tip) | $16.67M |
| 169 | H2024 | Supported employment, per diem | $16.47M |
| 170 | D0274 | Bitewings - four radiographic images | $15.98M |
| 171 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $15.98M |
| 172 | T4544 | Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each | $15.82M |
| 173 | 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | $15.79M |
| 174 | J2357 | Injection, omalizumab, 5 mg | $15.68M |
| 175 | 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 | $15.34M |
| 176 | 78815 | Positron emission tomography (PET) for limited area imaging | $15.02M |
| 177 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $14.83M |
| 178 | 90853 | Group psychotherapy (other than of a multiple-family group) | $14.80M |
| 179 | T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | $14.75M |
| 180 | V2020 | Frames, purchases | $14.74M |
| 181 | 70551 | Magnetic resonance imaging, brain; without contrast material | $14.73M |
| 182 | J1745 | Injection, infliximab, excludes biosimilar, 10 mg | $14.66M |
| 183 | T1002 | Rn services, up to 15 minutes | $14.52M |
| 184 | D0272 | Bitewings - two radiographic images | $14.42M |
| 185 | T4534 | Youth sized disposable incontinence product, protective underwear/pull-on, each | $14.41M |
| 186 | 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 | $14.40M |
| 187 | 95810 | Polysomnography; sleep staging with 4 or more additional parameters | $14.30M |
| 188 | 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $14.25M |
| 189 | 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | $14.14M |
| 190 | D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | $14.07M |
| 191 | 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 | $13.89M |
| 192 | 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | $13.65M |
| 193 | 90945 | $13.54M | |
| 194 | T1027 | Family training and counseling for child development, per 15 minutes | $13.52M |
| 195 | 96415 | $13.46M | |
| 196 | 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | $13.18M |
| 197 | 97162 | $13.11M | |
| 198 | 80305 | $12.72M | |
| 199 | 90686 | $12.59M | |
| 200 | 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | $12.45M |