Massachusetts Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Massachusetts, based on 2024 claims data.
2024 Overview
Procedures
2.8K
Total Claims
103.0M
Total Paid
$8.3B
Popular Services
Procedures
Showing 1–50 of 2,843 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| T1019 | Personal care ser per 15 min | 14,559,678 | $100.00 | $28.54 | $382.06 |
| S5140 | Adult foster care per diem | 5,955,877 | $93.94 | $62.67 | $2,602.23 |
| T2003 | N-et; encounter/trip | 3,043,063 | $37.51 | $15.41 | $1,045.52 |
| S5102 | Adult day care per diem | 2,623,544 | $141.29 | $11.65 | $3,835.70 |
| 99214 | Office o/p est mod 30 min | 2,238,769 | $55.26 | $0.00 | $600.60 |
| T1502 | Medication admin visit | 2,102,746 | $66.48 | $3.75 | $101.45 |
| 99213 | Office o/p est low 20 min | 1,866,088 | $41.07 | $0.00 | $468.67 |
| 99509 | Home visit day life activity | 1,527,642 | $58.24 | $52.79 | $102.76 |
| 85025 | Complete cbc w/auto diff wbc | 1,245,495 | $3.86 | $0.00 | $586.73 |
| H0043 | Supported housing, per diem | 1,160,147 | $54.82 | $0.00 | $1,349.43 |
| 36415 | Coll venous bld venipuncture | 1,084,115 | $0.63 | $0.00 | $59.27 |
| G0299 | Hhs/hospice of rn ea 15 min | 978,604 | $49.79 | $0.00 | $379.32 |
| 90834 | Psytx w pt 45 minutes | 962,568 | $67.61 | $0.00 | $440.00 |
| T1020 | Personal care ser per diem | 942,555 | $32.40 | $1.36 | $272.76 |
| T2025 | Waiver service, nos | 891,033 | $173.57 | $24.25 | $345.84 |
| S5170 | Homedelivered prepared meal | 839,936 | $25.66 | $9.84 | $292.09 |
| H2016 | Comp comm supp svc, per diem | 828,279 | $36.45 | $17.21 | $1,698.18 |
| 80053 | Comprehen metabolic panel | 826,818 | $4.63 | $0.00 | $320.81 |
| 90837 | Psytx w pt 60 minutes | 762,231 | $112.03 | $0.00 | $526.50 |
| S5130 | Homaker service nos per 15m | 746,469 | $101.75 | $0.00 | $1,270.47 |
| D0120 | Periodic oral evaluation | 727,684 | $25.55 | $0.00 | $84.42 |
| T1015 | Clinic service | 711,383 | $54.49 | $0.00 | $719.00 |
| 80307 | Drug test prsmv chem anlyzr | 696,708 | $37.11 | $0.00 | $285.85 |
| S5161 | Emer rspns sys serv permonth | 658,010 | $26.61 | $2.12 | $38.13 |
| T1040 | Comm bh clinic svc per diem | 655,776 | $214.94 | $0.00 | $242.41 |
| G2067 | Med assist tx meth wk | 636,603 | $171.07 | $0.00 | $256.05 |
| H0023 | Alcohol and/or drug outreach | 634,418 | $66.76 | $62.81 | $76.06 |
| 99284 | Emergency dept visit mod mdm | 599,256 | $129.27 | $0.00 | $1,001.29 |
| 97110 | Therapeutic exercises | 596,073 | $33.28 | $0.00 | $371.21 |
| A0170 | Transport parking fees/tolls | 591,405 | $5.59 | $1.22 | $5.73 |
| H2015 | Comp comm supp svc, 15 min | 585,159 | $164.46 | $0.94 | $849.51 |
| 83036 | Hemoglobin glycosylated a1c | 575,207 | $4.49 | $0.00 | $96.61 |
| 99285 | Emergency dept visit hi mdm | 570,778 | $145.20 | $0.00 | $933.22 |
| D1110 | Dental prophylaxis adult | 518,836 | $53.63 | $0.00 | $137.62 |
| T2022 | Case management, per month | 518,828 | $57.82 | $47.33 | $71.19 |
| G0463 | Hospital outpt clinic visit | 504,599 | $29.24 | $0.00 | $199.04 |
| 93010 | Electrocardiogram report | 494,976 | $4.09 | $0.00 | $156.95 |
| A0425 | Ground mileage | 490,466 | $35.23 | $0.00 | $248.08 |
| 80048 | Basic metabolic pnl total ca | 459,374 | $3.73 | $0.00 | $432.09 |
| 80061 | Lipid panel | 456,953 | $3.31 | $0.00 | $81.66 |
| 84443 | Assay thyroid stim hormone | 456,952 | $6.69 | $0.00 | $75.96 |
| 71046 | X-ray exam chest 2 views | 420,592 | $11.49 | $0.00 | $159.34 |
| D0220 | Intraoral periapical first | 397,558 | $15.24 | $0.00 | $34.00 |
| 99283 | Emergency dept visit low mdm | 394,156 | $159.24 | $0.00 | $621.58 |
| S0340 | Lifestyle mod 1st stage | 384,086 | $111.41 | $0.00 | $3,771.88 |
| D1120 | Dental prophylaxis child | 380,384 | $50.87 | $0.00 | $55.00 |
| D9450 | Case presentation tx plan | 368,047 | $53.08 | $0.00 | $110.00 |
| G0156 | Hhcp-svs of aide,ea 15 min | 356,509 | $39.10 | $0.00 | $747.14 |
| H2019 | Ther behav svc, per 15 min | 351,493 | $197.76 | $14.48 | $400.76 |
| D1206 | Topical fluoride varnish | 350,199 | $26.40 | $0.00 | $76.75 |