Delaware Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Delaware, based on 2024 claims data.
2024 Overview
Procedures
1.2K
Total Claims
6.4M
Total Paid
$635.5M
Popular Services
Procedures
Showing 1–50 of 1,245 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| S5130 | Homaker service nos per 15m | 569,816 | $210.07 | $0.00 | $4,641.84 |
| H0020 | Alcohol and/or drug services | 518,561 | $12.16 | $8.34 | $23.11 |
| S5125 | Attendant care service /15m | 231,535 | $151.95 | $14.28 | $3,739.21 |
| 99213 | Office o/p est low 20 min | 231,032 | $49.60 | $0.00 | $227.97 |
| 99214 | Office o/p est mod 30 min | 223,772 | $61.11 | $0.00 | $227.06 |
| T2025 | Waiver service, nos | 150,739 | $749.93 | $526.26 | $12,509.09 |
| T2020 | Day habil waiver per diem | 118,740 | $124.64 | $60.95 | $496.74 |
| D1206 | Topical fluoride varnish | 81,333 | $32.56 | $6.21 | $36.60 |
| D0120 | Periodic oral evaluation | 77,400 | $42.16 | $3.22 | $48.19 |
| 90837 | Psytx w pt 60 minutes | 76,064 | $59.15 | $0.00 | $163.73 |
| S5170 | Homedelivered prepared meal | 75,689 | $57.23 | $9.52 | $397.24 |
| 99283 | Emergency dept visit low mdm | 73,195 | $175.32 | $0.00 | $498.06 |
| 97530 | Therapeutic activities | 72,153 | $24.48 | $0.00 | $269.39 |
| T2016 | Habil res waiver per diem | 68,711 | $758.02 | $447.40 | $1,379.46 |
| T2004 | N-et; commerc carrier pass | 67,542 | $8.22 | $4.61 | $9.65 |
| 97110 | Therapeutic exercises | 66,965 | $24.57 | $0.07 | $355.63 |
| 99284 | Emergency dept visit mod mdm | 65,457 | $142.74 | $0.00 | $760.28 |
| D0603 | Caries risk assess high risk | 64,499 | $0.00 | $0.00 | $0.00 |
| 85025 | Complete cbc w/auto diff wbc | 62,271 | $14.27 | $0.00 | $76.01 |
| D1120 | Dental prophylaxis child | 58,024 | $55.58 | $0.00 | $61.61 |
| D1351 | Dental sealant per tooth | 54,864 | $45.30 | $0.00 | $49.41 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 50,029 | $43.09 | $0.40 | $139.43 |
| 3074F | Syst bp lt 130 mm hg | 48,665 | $0.06 | $0.00 | $9.33 |
| D0230 | Intraoral periapical ea add | 47,548 | $20.43 | $0.00 | $23.79 |
| 36415 | Coll venous bld venipuncture | 47,044 | $5.98 | $0.03 | $29.89 |
| T1001 | Nursing assessment/evaluatn | 46,792 | $68.65 | $0.93 | $176.21 |
| 96127 | Brief emotional/behav assmt | 44,521 | $6.11 | $0.00 | $19.16 |
| D0220 | Intraoral periapical first | 42,410 | $24.47 | $2.65 | $28.06 |
| 3078F | Diast bp <80 mm hg | 40,448 | $0.04 | $0.00 | $9.23 |
| 99285 | Emergency dept visit hi mdm | 37,940 | $144.11 | $0.00 | $1,237.06 |
| D1110 | Dental prophylaxis adult | 37,835 | $67.97 | $10.99 | $83.57 |
| 99211 | Off/op est may x req phy/qhp | 37,741 | $19.53 | $1.60 | $34.01 |
| G0175 | Opps service,sched team conf | 34,503 | $59.63 | $38.62 | $143.78 |
| T2023 | Targeted case mgmt per month | 33,096 | $132.29 | $77.02 | $194.05 |
| 3008F | Body mass index docd | 31,254 | $0.00 | $0.00 | $0.02 |
| G0467 | Fqhc visit, estab pt | 30,762 | $145.28 | $38.24 | $399.54 |
| 90460 | Im admin 1st/only component | 30,688 | $0.00 | $0.00 | $0.00 |
| 97112 | Neuromuscular reeducation | 30,595 | $21.75 | $0.00 | $75.78 |
| 80053 | Comprehen metabolic panel | 30,238 | $24.51 | $0.13 | $171.35 |
| 96160 | Pt-focused hlth risk assmt | 28,343 | $0.99 | $0.00 | $8.39 |
| D0274 | Bitewings four images | 27,635 | $49.51 | $8.36 | $57.95 |
| D8670 | Periodic orthodontc tx visit | 26,233 | $233.56 | $0.00 | $432.94 |
| D2392 | Post 2 srfc resinbased cmpst | 26,086 | $250.91 | $55.02 | $293.56 |
| 99173 | Visual acuity screen | 25,902 | $12.69 | $0.00 | $22.10 |
| T2014 | Habil prevoc waiver, per d | 24,729 | $69.90 | $41.04 | $122.45 |
| D0272 | Dental bitewings two images | 24,518 | $38.19 | $14.06 | $41.48 |
| 99203 | Office o/p new low 30 min | 24,316 | $71.48 | $0.00 | $142.84 |
| 93010 | Electrocardiogram report | 24,250 | $9.75 | $0.70 | $46.92 |
| 97140 | Manual therapy 1/> regions | 23,602 | $16.90 | $0.00 | $169.07 |
| T2040 | Financial mgt waiver/15min | 23,586 | $235.97 | $193.56 | $262.38 |