Illinois Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Illinois, based on 2024 claims data.
2024 Overview
Procedures
2.5K
Total Claims
62.0M
Total Paid
$3.3B
Popular Services
Procedures
Showing 1–50 of 2,481 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| T1015 | Clinic service | 3,227,840 | $155.32 | $1.68 | $405.25 |
| 99213 | Office o/p est low 20 min | 3,176,053 | $31.74 | $0.00 | $400.00 |
| 99214 | Office o/p est mod 30 min | 2,348,600 | $60.10 | $0.00 | $250.00 |
| 85025 | Complete cbc w/auto diff wbc | 1,445,742 | $3.57 | $0.00 | $19.06 |
| 80053 | Comprehen metabolic panel | 1,312,476 | $5.89 | $0.00 | $13.26 |
| 92508 | Tx sp lang voice comm group | 1,277,082 | $16.64 | $0.16 | $68.92 |
| H0004 | Alcohol and/or drug services | 1,210,442 | $117.13 | $25.59 | $1,471.02 |
| A0425 | Ground mileage | 999,777 | $65.73 | $0.00 | $534.55 |
| D0120 | Periodic oral evaluation | 817,801 | $26.43 | $0.00 | $50.13 |
| H2015 | Comp comm supp svc, 15 min | 793,997 | $129.64 | $16.57 | $475.63 |
| D1120 | Dental prophylaxis child | 752,385 | $38.55 | $0.00 | $73.40 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 644,517 | $40.15 | $0.00 | $80.11 |
| D0220 | Intraoral periapical first | 574,883 | $6.30 | $0.00 | $21.81 |
| 96164 | Hlth bhv ivntj grp 1st 30 | 560,307 | $9.68 | $0.30 | $35.35 |
| 99284 | Emergency dept visit mod mdm | 550,420 | $77.68 | $6.72 | $833.31 |
| T1016 | Case management | 536,237 | $88.32 | $31.94 | $1,889.38 |
| 93010 | Electrocardiogram report | 519,685 | $7.55 | $0.00 | $14.78 |
| D0230 | Intraoral periapical ea add | 504,422 | $5.96 | $0.00 | $38.80 |
| 92507 | Tx sp lang voice comm indiv | 497,727 | $35.41 | $0.25 | $116.65 |
| 80061 | Lipid panel | 489,381 | $7.10 | $0.00 | $57.15 |
| 83735 | Assay of magnesium | 486,423 | $3.71 | $0.00 | $6.81 |
| 84443 | Assay thyroid stim hormone | 483,372 | $10.96 | $0.00 | $16.80 |
| 83036 | Hemoglobin glycosylated a1c | 438,829 | $4.90 | $0.00 | $150.69 |
| 90837 | Psytx w pt 60 minutes | 433,751 | $105.23 | $0.00 | $167.20 |
| 92015 | Determine refractive state | 409,208 | $15.38 | $0.00 | $36.25 |
| A0120 | Noner transport mini-bus | 400,529 | $61.18 | $0.00 | $143.38 |
| D1208 | Topical app fluorid ex vrnsh | 399,729 | $26.31 | $0.00 | $30.03 |
| H2000 | Comp multidisipln evaluation | 397,669 | $122.93 | $26.87 | $574.85 |
| 80048 | Basic metabolic pnl total ca | 397,159 | $4.43 | $0.00 | $20.94 |
| 99309 | Sbsq nf care moderate mdm 30 | 395,792 | $31.79 | $0.00 | $117.29 |
| 99308 | Sbsq nf care low mdm 20 | 393,159 | $21.20 | $0.00 | $56.49 |
| 96158 | Hlth bhv ivntj indiv 1st 30 | 392,805 | $31.63 | $0.91 | $139.89 |
| 3008F | Body mass index docd | 390,538 | $0.00 | $0.00 | $0.00 |
| 36415 | Coll venous bld venipuncture | 387,686 | $3.83 | $0.00 | $8.69 |
| 3074F | Syst bp lt 130 mm hg | 382,012 | $0.00 | $0.00 | $0.10 |
| 99233 | Sbsq hosp ip/obs high 50 | 369,328 | $54.62 | $0.00 | $102.99 |
| 99285 | Emergency dept visit hi mdm | 366,365 | $105.87 | $13.68 | $407.97 |
| D1351 | Dental sealant per tooth | 356,028 | $58.42 | $0.00 | $293.61 |
| 85027 | Complete cbc automated | 350,711 | $3.45 | $0.00 | $8.69 |
| D1206 | Topical fluoride varnish | 341,817 | $21.64 | $0.00 | $46.55 |
| 3078F | Diast bp <80 mm hg | 332,415 | $0.00 | $0.00 | $0.08 |
| 81001 | Urinalysis auto w/scope | 324,547 | $1.73 | $0.00 | $3.32 |
| 99212 | Office o/p est sf 10 min | 318,244 | $18.19 | $0.00 | $108.62 |
| D0274 | Bitewings four images | 315,839 | $17.34 | $0.00 | $48.53 |
| 71045 | X-ray exam chest 1 view | 314,848 | $4.76 | $0.00 | $85.20 |
| 87491 | Chlmyd trach dna amp probe | 306,914 | $27.84 | $0.00 | $78.11 |
| 87591 | N.gonorrhoeae dna amp prob | 305,201 | $27.91 | $0.00 | $77.99 |
| H0005 | Alcohol and/or drug services | 296,699 | $91.00 | $23.98 | $143.56 |
| 87086 | Urine culture/colony count | 266,033 | $5.45 | $0.00 | $10.59 |
| 80307 | Drug test prsmv chem anlyzr | 265,629 | $35.69 | $0.00 | $62.14 |