All 2,688 procedure codes billed by Medicaid providers in West Virginia, ranked by total spending.
| # | Code | Description | Total Paid |
|---|---|---|---|
| 1 | S5125 | Attendant care services; per 15 minutes | $1.31B |
| 2 | T1015 | Clinic visit/encounter, all-inclusive | $859.57M |
| 3 | S5130 | Homemaker service, nos; per 15 minutes | $475.69M |
| 4 | 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) | $364.59M |
| 5 | 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | $313.55M |
| 6 | H2036 | Alcohol and/or other drug treatment program, per diem | $273.26M |
| 7 | H0004 | Behavioral health counseling and therapy, per 15 minutes | $246.57M |
| 8 | 99214 | Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | $229.34M |
| 9 | 99285 | Emergency department visit for the evaluation and management, high severity with immediate threat to life | $192.35M |
| 10 | 99284 | Emergency department visit for the evaluation and management, high severity | $186.32M |
| 11 | 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 | $143.71M |
| 12 | A0425 | Ground mileage, per statute mile | $130.96M |
| 13 | T2021 | Day habilitation, waiver; per 15 minutes | $125.22M |
| 14 | 99283 | Emergency department visit for the evaluation and management, moderate severity | $116.51M |
| 15 | G9002 | Coordinated care fee, maintenance rate | $110.93M |
| 16 | H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | $93.48M |
| 17 | H0038 | Self-help/peer services, per 15 minutes | $89.56M |
| 18 | H0040 | Assertive community treatment program, per diem | $82.00M |
| 19 | A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $79.51M |
| 20 | A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | $70.11M |
| 21 | H0036 | Community psychiatric supportive treatment, face-to-face, per 15 minutes | $69.64M |
| 22 | 97530 | Therapeutic activities, direct patient contact, each 15 minutes | $65.76M |
| 23 | A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | $61.42M |
| 24 | 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | $56.94M |
| 25 | 90837 | Psychotherapy, 53 minutes with patient | $55.89M |
| 26 | 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | $53.59M |
| 27 | 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | $53.08M |
| 28 | T1016 | Case management, each 15 minutes | $47.64M |
| 29 | T1000 | Private duty / independent nursing service(s) - licensed, up to 15 minutes | $42.91M |
| 30 | 74177 | Computed tomography, abdomen and pelvis; with contrast material | $42.53M |
| 31 | T1005 | Respite care services, up to 15 minutes | $42.24M |
| 32 | 99232 | Subsequent hospital care, per day, moderate complexity | $41.91M |
| 33 | E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | $41.85M |
| 34 | A4520 | Incontinence garment, any type, (e.g., brief, diaper), each | $40.16M |
| 35 | 80053 | Comprehensive metabolic panel | $38.27M |
| 36 | H0031 | Mental health assessment, by non-physician | $37.20M |
| 37 | T1002 | Rn services, up to 15 minutes | $35.12M |
| 38 | 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | $33.55M |
| 39 | 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | $32.84M |
| 40 | A0160 | Non-emergency transportation: per mile - case worker or social worker | $31.23M |
| 41 | 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | $29.12M |
| 42 | 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 | $27.24M |
| 43 | 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | $26.03M |
| 44 | 74176 | Computed tomography, abdomen and pelvis; without contrast material | $25.63M |
| 45 | 99203 | Office or other outpatient visit for the evaluation and management of a new patient, low complexity | $25.31M |
| 46 | 70450 | Computed tomography, head or brain; without contrast material | $24.59M |
| 47 | 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | $23.23M |
| 48 | G0482 | 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; 15-21 drug class(es), including metabolite(s) if performed | $22.51M |
| 49 | 36415 | Collection of venous blood by venipuncture | $21.07M |
| 50 | 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | $20.88M |
| 51 | 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | $19.31M |
| 52 | A0431 | Ambulance service, conventional air services, transport, one way (rotary wing) | $17.80M |
| 53 | 88305 | Level IV - Surgical pathology, gross and microscopic examination | $17.69M |
| 54 | T1003 | Lpn/lvn services, up to 15 minutes | $17.25M |
| 55 | D8090 | $17.11M | |
| 56 | 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | $16.97M |
| 57 | 41899 | Unlisted procedure, dentoalveolar structures | $16.94M |
| 58 | 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | $16.65M |
| 59 | S9083 | Global fee urgent care centers | $16.44M |
| 60 | E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | $16.42M |
| 61 | G0378 | Hospital observation service, per hour | $16.34M |
| 62 | 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $15.51M |
| 63 | 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | $15.16M |
| 64 | 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | $14.96M |
| 65 | 99233 | Prolong inpt eval add15 m | $14.92M |
| 66 | S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | $14.46M |
| 67 | 71045 | Radiologic examination, chest; single view | $14.37M |
| 68 | 71046 | Radiologic examination, chest; 2 views | $14.23M |
| 69 | 99282 | Emergency department visit for the evaluation and management, low to moderate severity | $13.73M |
| 70 | 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | $13.08M |
| 71 | D1120 | Prophylaxis - child | $13.06M |
| 72 | 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | $12.99M |
| 73 | 90834 | Psychotherapy, 45 minutes with patient | $12.67M |
| 74 | 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | $12.49M |
| 75 | 84443 | Thyroid stimulating hormone (TSH) | $12.35M |
| 76 | 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $12.13M |
| 77 | D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | $12.09M |
| 78 | 99223 | Prolong inpt eval add15 m | $11.84M |
| 79 | 90832 | Psychotherapy, 30 minutes with patient | $11.76M |
| 80 | 99215 | Prolong outpt/office vis | $11.73M |
| 81 | 96361 | Intravenous infusion, hydration; each additional hour | $11.35M |
| 82 | 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | $11.31M |
| 83 | 96375 | Therapeutic injection; each additional sequential IV push | $11.22M |
| 84 | 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | $11.13M |
| 85 | 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | $10.99M |
| 86 | 99222 | Initial hospital care, per day, moderate complexity | $10.96M |
| 87 | 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | $10.95M |
| 88 | D0120 | Periodic oral evaluation - established patient | $10.88M |
| 89 | T1017 | Targeted case management, each 15 minutes | $10.67M |
| 90 | 84484 | $10.58M | |
| 91 | J0178 | Injection, aflibercept, 1 mg | $10.36M |
| 92 | 80048 | Basic metabolic panel (calcium, ionized) | $10.32M |
| 93 | D1110 | Prophylaxis - adult | $9.88M |
| 94 | D7140 | Extraction, erupted tooth or exposed root | $9.83M |
| 95 | J9271 | Injection, pembrolizumab, 1 mg | $9.74M |
| 96 | 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | $9.66M |
| 97 | 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | $9.55M |
| 98 | H2015 | Comprehensive community support services, per 15 minutes | $9.55M |
| 99 | 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | $9.41M |
| 100 | A0436 | Rotary wing air mileage, per statute mile | $9.31M |
| 101 | J2405 | Injection, ondansetron hydrochloride, per 1 mg | $9.19M |
| 102 | A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | $9.16M |
| 103 | D1351 | Sealant - per tooth | $8.96M |
| 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 | $8.77M |
| 105 | 81001 | $8.63M | |
| 106 | D0330 | Panoramic radiographic image | $8.38M |
| 107 | H0032 | Mental health service plan development by non-physician | $8.37M |
| 108 | 90935 | Hemodialysis procedure with single evaluation by a physician | $8.35M |
| 109 | Q3014 | Telehealth originating site facility fee | $8.33M |
| 110 | D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | $8.28M |
| 111 | D1208 | Topical application of fluoride, excluding varnish | $8.18M |
| 112 | V2020 | Frames, purchases | $8.18M |
| 113 | 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | $8.13M |
| 114 | 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | $8.06M |
| 115 | 80061 | Lipid panel | $8.04M |
| 116 | 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 | $7.97M |
| 117 | D2391 | Resin-based composite - one surface, posterior, primary or permanent | $7.95M |
| 118 | 82075 | $7.94M | |
| 119 | 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | $7.87M |
| 120 | 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | $7.67M |
| 121 | D0140 | Limited oral evaluation - problem focused | $7.49M |
| 122 | Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | $7.20M |
| 123 | 71275 | Computed tomographic angiography, chest, with contrast material | $7.19M |
| 124 | 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | $7.09M |
| 125 | 99231 | Subsequent hospital care, per day, straightforward or low complexity | $7.01M |
| 126 | 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | $6.98M |
| 127 | 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | $6.98M |
| 128 | 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | $6.97M |
| 129 | J3490 | Unclassified drugs | $6.93M |
| 130 | D8680 | $6.92M | |
| 131 | 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | $6.91M |
| 132 | 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | $6.90M |
| 133 | 71260 | Computed tomography, thorax, diagnostic; with contrast material | $6.84M |
| 134 | 90792 | Psychiatric diagnostic evaluation with medical services | $6.82M |
| 135 | 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | $6.80M |
| 136 | 81025 | $6.70M | |
| 137 | 87086 | Culture, bacterial; quantitative colony count, urine | $6.62M |
| 138 | 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | $6.58M |
| 139 | 83605 | $6.58M | |
| 140 | 90999 | Unlisted dialysis procedure, inpatient or outpatient | $6.53M |
| 141 | 80305 | $6.50M | |
| 142 | 90853 | Group psychotherapy (other than of a multiple-family group) | $6.43M |
| 143 | D0999 | Unspecified diagnostic procedure, by report | $6.36M |
| 144 | 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | $6.29M |
| 145 | 95165 | Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials | $6.28M |
| 146 | J1100 | Injection, dexamethasone sodium phosphate, 1 mg | $6.27M |
| 147 | 77067 | Screening mammography, bilateral, including computer-aided detection | $6.27M |
| 148 | 96156 | $6.22M | |
| 149 | 85027 | $6.04M | |
| 150 | 70553 | Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences | $5.89M |
| 151 | E2402 | Negative pressure wound therapy electrical pump, stationary or portable | $5.85M |
| 152 | 83690 | $5.84M | |
| 153 | G9007 | Coordinated care fee, scheduled team conference | $5.77M |
| 154 | J3010 | Injection, fentanyl citrate, 0.1 mg | $5.75M |
| 155 | D2930 | Prefabricated stainless steel crown - primary tooth | $5.72M |
| 156 | J2250 | Injection, midazolam hydrochloride, per 1 mg | $5.70M |
| 157 | 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | $5.61M |
| 158 | 83735 | $5.57M | |
| 159 | 90791 | Psychiatric diagnostic evaluation | $5.56M |
| 160 | A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | $5.48M |
| 161 | 83036 | Hemoglobin; glycosylated (A1C) | $5.42M |
| 162 | T1001 | Nursing assessment / evaluation | $5.42M |
| 163 | 93458 | $5.34M | |
| 164 | 72125 | Computed tomography, cervical spine; without contrast material | $5.32M |
| 165 | 76830 | Ultrasound, transvaginal | $5.21M |
| 166 | 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | $5.18M |
| 167 | 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | $5.17M |
| 168 | G0463 | Hospital outpatient clinic visit for assessment and management of a patient | $5.16M |
| 169 | 85610 | $5.16M | |
| 170 | 90472 | Immunization administration, each additional vaccine (list separately) | $5.14M |
| 171 | 76705 | Ultrasound, abdominal, real time with image documentation; limited | $5.12M |
| 172 | J2704 | Injection, propofol, 10 mg | $5.10M |
| 173 | 99205 | Prolong outpt/office vis | $4.91M |
| 174 | J1885 | Injection, ketorolac tromethamine, per 15 mg | $4.88M |
| 175 | T1040 | Medicaid certified community behavioral health clinic services, per diem | $4.74M |
| 176 | D8080 | Comprehensive orthodontic treatment of the adolescent dentition | $4.74M |
| 177 | 99238 | Hospital discharge day management, 30 minutes or less | $4.72M |
| 178 | J7120 | Ringers lactate infusion, up to 1000 cc | $4.64M |
| 179 | 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | $4.44M |
| 180 | 99342 | $4.41M | |
| 181 | 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | $4.34M |
| 182 | T2024 | Service assessment/plan of care development, waiver | $4.30M |
| 183 | T2001 | Non-emergency transportation; patient attendant/escort | $4.27M |
| 184 | E0601 | Continuous positive airway pressure (cpap) device | $4.19M |
| 185 | E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | $4.16M |
| 186 | D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | $4.05M |
| 187 | J0585 | Injection, onabotulinumtoxina, 1 unit | $4.01M |
| 188 | A4554 | Disposable underpads, all sizes | $3.99M |
| 189 | 99239 | Hospital discharge day management, more than 30 minutes | $3.91M |
| 190 | 87040 | $3.87M | |
| 191 | 71250 | $3.81M | |
| 192 | 85730 | $3.72M | |
| 193 | 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | $3.70M |
| 194 | 83880 | $3.67M | |
| 195 | 78815 | Positron emission tomography (PET) for limited area imaging | $3.65M |
| 196 | A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | $3.63M |
| 197 | A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | $3.60M |
| 198 | T2019 | Habilitation, supported employment, waiver; per 15 minutes | $3.56M |
| 199 | 20610 | $3.50M | |
| 200 | J0690 | Injection, cefazolin sodium, 500 mg | $3.48M |