T-MSIS provider-level spending data, Jan 2018 – Dec 2024
Total Procedures
10,881
6,058 shown
Highest Spending
T1019
Personal care ser per 15 min $122.74B
Highest $/Beneficiary
Q4282
$127,597 per beneficiary
Each dot is a procedure code. Size = total spending. Color = HCPCS category.
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| # | HCPCS Code | Category | Total Paid▼ | Avg $/Claim | Avg $/Beneficiary | Claims/Bene | Providers |
|---|---|---|---|---|---|---|---|
| 1 | T1019 Personal care ser per 15 min | State Medicaid | $122.74B | $112 | $2,203 | 19.8 | 9,780 |
| 2 | T1015 Clinic service | State Medicaid | $49.15B | $153 | $209 | 1.4 | 13,829 |
| 3 | T2016 Habil res waiver per diem | State Medicaid | $34.90B | $506 | $7,951 | 15.7 | 1,761 |
| 4 | 99213 Established patient office visit, low complexity | E&M | $33.00B | $43 | $52 | 1.2 | 164,075 |
| 5 | S5125 Attendant care service /15m | Private Payer | $31.34B | $79 | $1,614 | 20.5 | 4,555 |
| 6 | 99214 Established patient office visit, moderate complexity | E&M | $29.91B | $60 | $69 | 1.2 | 150,306 |
| 7 | 99284 Emergency department visit, high complexity | E&M | $20.15B | $118 | $130 | 1.1 | 21,452 |
| 8 | H2016 Comp comm supp svc, per diem | Behavioral Health | $19.75B | $325 | $4,686 | 14.4 | 2,115 |
| 9 | 99283 Emergency department visit, moderate complexity | E&M | $16.87B | $107 | $117 | 1.1 | 20,157 |
| 10 | H2015 Comp comm supp svc, 15 min | Behavioral Health | $16.47B | $150 | $791 | 5.3 | 3,908 |
| 11 | 99285 Emergency department visit, high complexity/urgent | E&M | $15.10B | $136 | $151 | 1.1 | 17,705 |
| 12 | 90837 Psychotherapy, 60 minutes with patient | Medicine | $12.07B | $95 | $212 | 2.2 | 44,034 |
| 13 | S5102 Adult day care per diem | Private Payer | $9.34B | $84 | $1,247 | 14.8 | 2,146 |
| 14 | 90834 Psychotherapy, 45 minutes with patient | Medicine | $8.82B | $81 | $162 | 2.0 | 27,908 |
| 15 | T2021 Day habil waiver per 15 min | State Medicaid | $8.65B | $156 | $1,599 | 10.3 | 2,363 |
| 16 | H2017 Psysoc rehab svc, per 15 min | Behavioral Health | $8.54B | $109 | $614 | 5.7 | 4,499 |
| 17 | T1017 Targeted case management | State Medicaid | $8.42B | $112 | $281 | 2.5 | 4,498 |
| 18 | T1020 Personal care ser per diem | State Medicaid | $8.21B | $245 | $1,571 | 6.4 | 1,038 |
| 19 | 90999 Unlisted dialysis procedure | Medicine | $7.74B | $86 | $1,114 | 13.0 | 4,989 |
| 20 | A0427 Als1-emergency | Transport & DME | $7.67B | $229 | $278 | 1.2 | 5,789 |
| 21 | 92507 Speech/language treatment, individual | Medicine | $7.48B | $58 | $209 | 3.6 | 16,583 |
| 22 | H2019 Ther behav svc, per 15 min | Behavioral Health | $7.47B | $107 | $398 | 3.7 | 5,661 |
| 23 | T2033 Res, nos waiver per diem | State Medicaid | $7.42B | $448 | $5,895 | 13.2 | 716 |
| 24 | T1000 Private duty/independent nsg | State Medicaid | $7.01B | $418 | $9,179 | 22.0 | 489 |
| 25 | H2014 Skills train and dev, 15 min | Behavioral Health | $6.76B | $111 | $729 | 6.5 | 3,858 |
6,058 rows · Page 1 of 243