Kentucky Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Kentucky, based on 2024 claims data.
2024 Overview
Procedures
2.7K
Total Claims
57.9M
Total Paid
$3.9B
Popular Services
Procedures
Showing 1–50 of 2,677 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99213 | Office o/p est low 20 min | 3,876,177 | $33.15 | $0.00 | $209.45 |
| S5108 | Homecare train pt 15 min | 2,061,445 | $203.02 | $41.32 | $1,972.49 |
| 99214 | Office o/p est mod 30 min | 2,051,868 | $47.95 | $0.00 | $160.57 |
| 36415 | Coll venous bld venipuncture | 1,370,710 | $5.61 | $0.00 | $33.90 |
| 97535 | Self care mngment training | 1,242,955 | $155.23 | $0.00 | $563.10 |
| H0038 | Self-help/peer svc per 15min | 1,121,153 | $29.55 | $0.00 | $289.31 |
| 90837 | Psytx w pt 60 minutes | 1,085,185 | $77.08 | $0.00 | $1,371.48 |
| T2016 | Habil res waiver per diem | 1,027,709 | $228.78 | $90.67 | $358.15 |
| 99284 | Emergency dept visit mod mdm | 875,911 | $148.91 | $0.00 | $795.20 |
| 80053 | Comprehen metabolic panel | 858,584 | $12.37 | $0.00 | $119.74 |
| 85025 | Complete cbc w/auto diff wbc | 809,322 | $7.27 | $0.00 | $48.14 |
| 80307 | Drug test prsmv chem anlyzr | 799,539 | $35.03 | $0.00 | $141.86 |
| H2027 | Psychoed svc, per 15 min | 572,580 | $250.30 | $0.00 | $847.69 |
| 3008F | Body mass index docd | 554,884 | $0.00 | $0.00 | $0.07 |
| T1019 | Personal care ser per 15 min | 534,590 | $208.64 | $50.56 | $444.03 |
| T2021 | Day habil waiver per 15 min | 524,370 | $79.80 | $22.11 | $438.12 |
| 97110 | Therapeutic exercises | 512,589 | $31.60 | $0.00 | $287.38 |
| 99285 | Emergency dept visit hi mdm | 484,570 | $174.79 | $0.00 | $1,319.45 |
| 90832 | Psytx w pt 30 minutes | 480,589 | $39.38 | $0.00 | $107.04 |
| 87880 | Strep a assay w/optic | 473,019 | $11.71 | $0.00 | $46.75 |
| 99283 | Emergency dept visit low mdm | 468,394 | $156.35 | $5.84 | $423.57 |
| G0463 | Hospital outpt clinic visit | 461,865 | $36.93 | $0.00 | $161.69 |
| 97530 | Therapeutic activities | 454,832 | $49.75 | $0.00 | $381.03 |
| 92508 | Tx sp lang voice comm group | 453,288 | $5.26 | $0.00 | $14.36 |
| 92507 | Tx sp lang voice comm indiv | 428,091 | $45.00 | $0.00 | $353.96 |
| H2015 | Comp comm supp svc, 15 min | 422,991 | $87.51 | $0.00 | $1,187.22 |
| 87804 | Influenza assay w/optic | 410,016 | $13.89 | $0.00 | $54.07 |
| T1040 | Comm bh clinic svc per diem | 400,630 | $3.89 | $0.00 | $130.90 |
| 71045 | X-ray exam chest 1 view | 393,644 | $22.49 | $0.00 | $184.24 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 385,700 | $29.04 | $0.00 | $79.18 |
| 3074F | Syst bp lt 130 mm hg | 384,661 | $0.00 | $0.00 | $15.00 |
| S5100 | Adult daycare services 15min | 351,451 | $85.35 | $0.00 | $427.48 |
| H0020 | Alcohol and/or drug services | 340,663 | $92.80 | $0.00 | $120.12 |
| H0015 | Alcohol and/or drug services | 338,542 | $113.29 | $0.00 | $317.53 |
| H0011 | Alcohol and/or drug services | 337,392 | $285.15 | $0.00 | $3,161.94 |
| 3078F | Diast bp <80 mm hg | 334,935 | $0.00 | $0.00 | $14.29 |
| 99212 | Office o/p est sf 10 min | 329,098 | $28.22 | $0.00 | $149.63 |
| 93010 | Electrocardiogram report | 324,727 | $6.92 | $0.00 | $32.24 |
| G0480 | Drug test def 1-7 classes | 310,610 | $57.37 | $0.00 | $231.01 |
| D1120 | Dental prophylaxis child | 290,161 | $58.81 | $0.00 | $712.42 |
| T2023 | Targeted case mgmt per month | 285,937 | $310.63 | $0.00 | $587.39 |
| G0481 | Drug test def 8-14 classes | 277,527 | $64.54 | $0.00 | $173.17 |
| 98941 | Chiropract manj 3-4 regions | 272,749 | $19.31 | $0.00 | $28.03 |
| 96372 | Ther/proph/diag inj sc/im | 269,187 | $26.34 | $0.00 | $178.33 |
| D0120 | Periodic oral evaluation | 266,076 | $27.09 | $0.00 | $71.99 |
| 99211 | Off/op est may x req phy/qhp | 253,186 | $16.08 | $0.00 | $92.97 |
| V2020 | Vision svcs frames purchases | 246,274 | $18.71 | $0.00 | $85.94 |
| 80061 | Lipid panel | 245,270 | $12.32 | $0.00 | $86.33 |
| D1206 | Topical fluoride varnish | 240,726 | $18.86 | $0.00 | $452.13 |
| 83036 | Hemoglobin glycosylated a1c | 234,175 | $7.53 | $0.00 | $85.37 |