All 1,145 procedure codes billed by Medicaid providers in Vermont, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | 99199 | Unlisted special service, procedure or report | $955.23M |
| 2 | H2022 | Community-based wrap-around services, per diem | $497.98M |
| 3 | T1015 | Clinic visit/encounter, all-inclusive | $233.79M |
| 4 | H2015 | Comprehensive community support services, per 15 minutes | $135.51M |
| 5 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $122.59M |
| 6 | H2017 | Psychosocial rehabilitation services, per 15 minutes | $116.02M |
| 7 | 90837 | Psychotherapy, 53 minutes with patient | $96.09M |
| 8 | H0023 | Behavioral health outreach service (planned approach to reach a targeted population) | $86.97M |
| 9 | T1024 | Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter | $58.96M |
| 10 | H2020 | Therapeutic behavioral services, per diem | $49.20M |
| 11 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $47.20M |
| 12 | H0046 | Mental health services, not otherwise specified | $40.18M |
| 13 | 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 | $39.43M |
| 14 | H0018 | Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem | $33.47M |
| 15 | G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) | $32.57M |
| 16 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $28.25M |
| 17 | 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) | $19.61M |
| 18 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $14.81M |
| 19 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $12.75M |
| 20 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $11.88M |
| 21 | D1110 | Prophylaxis - adult | $11.02M |
| 22 | T2025 | Waiver services; not otherwise specified (nos) | $10.32M |
| 23 | A0425 | Ground mileage, per statute mile | $9.63M |
| 24 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $9.18M |
| 25 | D0120 | Periodic oral evaluation - established patient | $9.01M |
| 26 | T2033 | Residential care, not otherwise specified (nos), waiver; per diem | $8.97M |
| 27 | 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 | $8.94M |
| 28 | H2014 | Skills training and development, per 15 minutes | $8.45M |
| 29 | H0011 | Alcohol and/or drug services; acute detoxification (residential addiction program inpatient) | $7.43M |
| 30 | 99284 | Emergency department visit for the evaluation and management, high severity | $7.20M |
| 31 | D1120 | Prophylaxis - child | $6.75M |
| 32 | D1206 | Topical application of fluoride varnish | $6.16M |
| 33 | 90834 | Psychotherapy, 45 minutes with patient | $5.93M |
| 34 | T2021 | Day habilitation, waiver; per 15 minutes | $5.79M |
| 35 | S5146 | Foster care, therapeutic, child; per month | $5.74M |
| 36 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $4.94M |
| 37 | S9485 | Crisis intervention mental health services, per diem | $4.86M |
| 38 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $4.70M |
| 39 | D7140 | Extraction, erupted tooth or exposed root | $4.55M |
| 40 | T2022 | Case management, per month | $4.47M |
| 41 | G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | $4.29M |
| 42 | 99215 | Prolong outpt/office vis | $4.29M |
| 43 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $4.26M |
| 44 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $4.12M |
| 45 | J0575 | Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine | $3.86M |
| 46 | D0140 | Limited oral evaluation - problem focused | $3.62M |
| 47 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $3.51M |
| 48 | J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | $3.38M |
| 49 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $3.37M |
| 50 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $3.28M |
| 51 | D0274 | Bitewings - four radiographic images | $3.24M |
| 52 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $3.21M |
| 53 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $3.16M |
| 54 | H0005 | Alcohol and/or drug services; group counseling by a clinician | $3.16M |
| 55 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $3.14M |
| 56 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $3.13M |
| 57 | 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 | $3.04M |
| 58 | D0330 | Panoramic radiographic image | $2.98M |
| 59 | D0150 | Comprehensive oral evaluation - new or established patient | $2.92M |
| 60 | T2023 | Targeted case management; per month | $2.63M |
| 61 | 99232 | Subsequent hospital care, per day, moderate complexity | $2.61M |
| 62 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $2.60M |
| 63 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $2.60M |
| 64 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $2.49M |
| 65 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $2.43M |
| 66 | S9480 | Intensive outpatient psychiatric services, per diem | $2.38M |
| 67 | D1351 | Sealant - per tooth | $2.36M |
| 68 | T1027 | Family training and counseling for child development, per 15 minutes | $2.35M |
| 69 | 90832 | Psychotherapy, 30 minutes with patient | $2.09M |
| 70 | 92015 | Determination of refractive state | $1.99M |
| 71 | T1017 | Targeted case management, each 15 minutes | $1.96M |
| 72 | G2078 | Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | $1.94M |
| 73 | H2011 | Crisis intervention service, per 15 minutes | $1.92M |
| 74 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $1.91M |
| 75 | D7240 | Removal of impacted tooth - completely bony | $1.72M |
| 76 | E0603 | Breast pump, electric (ac and/or dc), any type | $1.71M |
| 77 | G2074 | Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) | $1.69M |
| 78 | A7030 | Full face mask used with positive airway pressure device, each | $1.62M |
| 79 | D9222 | $1.58M | |
| 80 | S9443 | Lactation classes, non-physician provider, per session | $1.58M |
| 81 | E0601 | Continuous positive airway pressure (cpap) device | $1.50M |
| 82 | 90460 | Immunization administration through 18 years of age via any route, first or only component | $1.41M |
| 83 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $1.37M |
| 84 | 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | $1.34M |
| 85 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $1.27M |
| 86 | 99233 | Prolong inpt eval add15 m | $1.24M |
| 87 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $1.23M |
| 88 | 98942 | $1.22M | |
| 89 | D0272 | Bitewings - two radiographic images | $1.22M |
| 90 | D9223 | Deep sedation/general anesthesia - each subsequent 15 minute increment | $1.21M |
| 91 | D0220 | Intraoral - periapical first radiographic image | $1.21M |
| 92 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $1.19M |
| 93 | D0210 | Intraoral - complete series of radiographic images | $1.19M |
| 94 | S9128 | Speech therapy, in the home, per diem | $1.17M |
| 95 | T1016 | Case management, each 15 minutes | $1.15M |
| 96 | A7031 | Face mask interface, replacement for full face mask, each | $1.12M |
| 97 | D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | $1.11M |
| 98 | D4346 | $982K | |
| 99 | 90847 | Family psychotherapy with the patient present, 50 minutes | $887K |
| 100 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $877K |
| 101 | L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | $873K |
| 102 | 90791 | Psychiatric diagnostic evaluation | $835K |
| 103 | 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 | $833K |
| 104 | 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | $823K |
| 105 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $819K |
| 106 | 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 | $812K |
| 107 | J0572 | Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine | $756K |
| 108 | D4341 | $754K | |
| 109 | T1013 | Sign language or oral interpretive services, per 15 minutes | $705K |
| 110 | 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | $705K |
| 111 | J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | $701K |
| 112 | H0040 | Assertive community treatment program, per diem | $693K |
| 113 | A4604 | Tubing with integrated heating element for use with positive airway pressure device | $690K |
| 114 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $686K |
| 115 | H0032 | Mental health service plan development by non-physician | $684K |
| 116 | H0010 | Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) | $664K |
| 117 | G2076 | Intake activities, including initial medical examination that is conducted by an appropriately licensed practitioner and preparation of a care plan, which may be informed by administration of a standardized, evidence-based assessment, and that includes the patient's goals and mutually agreed-upon actions for the patient to meet those goals, including harm reduction interventions; the patient's needs and goals in the areas of education, vocational training, and employment; and the medical and psychiatric, psychosocial, economic, legal, housing, physical activity and/or nutrition needs and other recovery support services that a patient needs and wishes to pursue, conducted by an appropriately licensed/credentialed personnel (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to each primary code | $657K |
| 118 | 67028 | Intravitreal injection of a pharmacologic agent | $645K |
| 119 | D8080 | Comprehensive orthodontic treatment of the adolescent dentition | $645K |
| 120 | 92340 | Fitting of spectacles, except for aphakia; monofocal | $632K |
| 121 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $622K |
| 122 | E2402 | Negative pressure wound therapy electrical pump, stationary or portable | $618K |
| 123 | 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | $605K |
| 124 | D1208 | Topical application of fluoride, excluding varnish | $600K |
| 125 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $598K |
| 126 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $593K |
| 127 | 70450 | Computed tomography, head or brain; without contrast material | $530K |
| 128 | 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | $503K |
| 129 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $499K |
| 130 | 90853 | Group psychotherapy (other than of a multiple-family group) | $498K |
| 131 | 87428 | $496K | |
| 132 | 97803 | $489K | |
| 133 | E0562 | Humidifier, heated, used with positive airway pressure device | $488K |
| 134 | T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | $481K |
| 135 | 71046 | Radiologic examination, chest; 2 views | $475K |
| 136 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $465K |
| 137 | H2000 | Comprehensive multidisciplinary evaluation | $461K |
| 138 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $451K |
| 139 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $445K |
| 140 | D1354 | $443K | |
| 141 | 80305 | $420K | |
| 142 | A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | $414K |
| 143 | H2019 | Therapeutic behavioral services, per 15 minutes | $384K |
| 144 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $374K |
| 145 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $371K |
| 146 | 90461 | $351K | |
| 147 | S4993 | Contraceptive pills for birth control | $348K |
| 148 | A7038 | Filter, disposable, used with positive airway pressure device | $345K |
| 149 | 80053 | Comprehensive metabolic panel | $345K |
| 150 | E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | $344K |
| 151 | 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | $343K |
| 152 | 77067 | Screening mammography, bilateral, including computer-aided detection | $334K |
| 153 | A7035 | Headgear used with positive airway pressure device | $328K |
| 154 | 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | $328K |
| 155 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $327K |
| 156 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $318K |
| 157 | 99223 | Prolong inpt eval add15 m | $313K |
| 158 | T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | $313K |
| 159 | H0001 | Alcohol and/or drug assessment | $312K |
| 160 | J0573 | Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine | $304K |
| 161 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $302K |
| 162 | 90472 | Immunization administration, each additional vaccine (list separately) | $300K |
| 163 | 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | $299K |
| 164 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $298K |
| 165 | D2930 | Prefabricated stainless steel crown - primary tooth | $296K |
| 166 | G9001 | Coordinated care fee, initial rate | $296K |
| 167 | 99309 | Subsequent nursing facility care, per day, low to moderate complexity | $291K |
| 168 | 96133 | $291K | |
| 169 | 36415 | Collection of venous blood by venipuncture | $290K |
| 170 | 99231 | Subsequent hospital care, per day, straightforward or low complexity | $289K |
| 171 | H0006 | Alcohol and/or drug services; case management | $284K |
| 172 | T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | $280K |
| 173 | D4910 | $280K | |
| 174 | T1030 | Nursing care, in the home, by registered nurse, per diem | $271K |
| 175 | A0998 | Ambulance response and treatment, no transport | $260K |
| 176 | 90792 | Psychiatric diagnostic evaluation with medical services | $258K |
| 177 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $256K |
| 178 | D4342 | $256K | |
| 179 | 71045 | Radiologic examination, chest; single view | $252K |
| 180 | E0570 | Nebulizer, with compressor | $248K |
| 181 | T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | $239K |
| 182 | D0230 | Intraoral - periapical each additional radiographic image | $237K |
| 183 | A7032 | Cushion for use on nasal mask interface, replacement only, each | $236K |
| 184 | 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) | $236K |
| 185 | L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | $235K |
| 186 | D9243 | $235K | |
| 187 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $233K |
| 188 | D0470 | $231K | |
| 189 | J0586 | Injection, abobotulinumtoxina, 5 units | $230K |
| 190 | 80051 | $230K | |
| 191 | 77063 | Screening digital breast tomosynthesis, bilateral | $230K |
| 192 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $221K |
| 193 | D9920 | $219K | |
| 194 | D1330 | $215K | |
| 195 | D7250 | $209K | |
| 196 | D0340 | $209K | |
| 197 | D9310 | $203K | |
| 198 | 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | $202K |
| 199 | J0178 | Injection, aflibercept, 1 mg | $202K |
| 200 | A0394 | Als specialized service disposable supplies; iv drug therapy | $201K |