District of Columbia Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in District of Columbia, based on 2024 claims data.
2024 Overview
Procedures
1.3K
Total Claims
8.4M
Total Paid
$1.0B
Popular Services
Procedures
Showing 1–50 of 1,254 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| H0036 | Comm psy face-face per 15min | 2,228,135 | $96.00 | $0.00 | $382.80 |
| T1019 | Personal care ser per 15 min | 979,798 | $167.28 | $0.00 | $255.71 |
| T1015 | Clinic service | 257,809 | $128.20 | $0.00 | $872.80 |
| 99214 | Office o/p est mod 30 min | 244,347 | $109.06 | $0.00 | $362.04 |
| 99213 | Office o/p est low 20 min | 172,142 | $89.22 | $0.00 | $411.70 |
| H0020 | Alcohol and/or drug services | 154,915 | $18.60 | $0.00 | $125.96 |
| T2016 | Habil res waiver per diem | 137,396 | $589.24 | $416.80 | $727.26 |
| H0044 | Supported housing, per month | 132,573 | $273.34 | $0.00 | $785.72 |
| 99284 | Emergency dept visit mod mdm | 117,444 | $162.39 | $19.97 | $608.25 |
| H0039 | Asser com tx face-face/15min | 112,029 | $93.51 | $0.00 | $1,187.72 |
| 90837 | Psytx w pt 60 minutes | 99,474 | $116.60 | $0.00 | $404.40 |
| H0025 | Alcohol and/or drug preventi | 96,836 | $109.13 | $2.19 | $489.67 |
| T2031 | Assist living waiver/diem | 87,502 | $206.53 | $138.71 | $224.66 |
| T2021 | Day habil waiver per 15 min | 72,301 | $180.27 | $105.29 | $253.45 |
| 99285 | Emergency dept visit hi mdm | 71,321 | $175.92 | $26.12 | $636.29 |
| 99212 | Office o/p est sf 10 min | 71,267 | $250.84 | $0.00 | $414.14 |
| 99509 | Home visit day life activity | 69,667 | $169.15 | $9.34 | $231.67 |
| 93010 | Electrocardiogram report | 69,096 | $5.02 | $0.19 | $8.53 |
| 99283 | Emergency dept visit low mdm | 67,678 | $246.36 | $9.94 | $550.75 |
| 90999 | Unlisted dialysis procedure | 67,507 | $82.67 | $6.54 | $164.87 |
| 71045 | X-ray exam chest 1 view | 61,302 | $4.42 | $0.00 | $20.25 |
| 99215 | Office o/p est hi 40 min | 55,999 | $148.32 | $0.00 | $467.60 |
| D0120 | Periodic oral evaluation | 51,694 | $29.72 | $0.00 | $37.69 |
| 97110 | Therapeutic exercises | 45,090 | $105.46 | $0.00 | $326.03 |
| H0004 | Alcohol and/or drug services | 44,920 | $40.88 | $0.00 | $172.21 |
| G0299 | Hhs/hospice of rn ea 15 min | 44,137 | $112.32 | $0.00 | $515.91 |
| 97530 | Therapeutic activities | 42,667 | $71.33 | $0.00 | $277.43 |
| 85025 | Complete cbc w/auto diff wbc | 41,477 | $1.19 | $0.00 | $9.25 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 39,788 | $46.95 | $2.48 | $81.61 |
| A0425 | Ground mileage | 38,498 | $86.30 | $0.00 | $451.03 |
| D0220 | Intraoral periapical first | 36,542 | $15.11 | $0.00 | $45.33 |
| T1000 | Private duty/independent nsg | 35,204 | $358.13 | $0.00 | $953.85 |
| 99233 | Sbsq hosp ip/obs high 50 | 35,066 | $73.09 | $1.66 | $122.03 |
| 71046 | X-ray exam chest 2 views | 34,150 | $13.07 | $0.00 | $59.02 |
| 90853 | Group psychotherapy | 31,840 | $23.79 | $0.00 | $173.56 |
| 90791 | Psych diagnostic evaluation | 31,818 | $155.52 | $0.00 | $653.79 |
| H2014 | Skills train and dev, 15 min | 31,329 | $64.44 | $0.00 | $183.06 |
| D1206 | Topical fluoride varnish | 30,805 | $25.40 | $0.00 | $30.95 |
| D1120 | Dental prophylaxis child | 29,286 | $43.52 | $0.00 | $48.90 |
| D1110 | Dental prophylaxis adult | 29,274 | $63.85 | $0.00 | $83.18 |
| G0463 | Hospital outpt clinic visit | 29,246 | $209.29 | $3.93 | $470.44 |
| 97112 | Neuromuscular reeducation | 28,879 | $52.71 | $0.00 | $209.89 |
| 70450 | Ct head/brain w/o dye | 28,111 | $140.54 | $12.08 | $686.02 |
| S5100 | Adult daycare services 15min | 28,028 | $138.05 | $90.21 | $147.81 |
| D1208 | Topical app fluorid ex vrnsh | 27,993 | $23.80 | $0.00 | $26.73 |
| D0230 | Intraoral periapical ea add | 25,751 | $13.25 | $0.00 | $64.78 |
| A0429 | Bls-emergency | 25,701 | $1,376.25 | $992.37 | $1,698.22 |
| 80053 | Comprehen metabolic panel | 25,478 | $3.39 | $0.00 | $19.06 |
| D0999 | Unspecified diagnostic proce | 24,870 | $79.05 | $0.00 | $255.23 |
| 97150 | Group therapeutic procedures | 24,454 | $45.57 | $2.82 | $303.69 |