Minnesota Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Minnesota, based on 2024 claims data.
2024 Overview
Procedures
2.2K
Total Claims
38.4M
Total Paid
$4.1B
Popular Services
Procedures
Showing 51–100 of 2,156 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 93010 | Electrocardiogram report | 166,654 | $6.13 | $0.00 | $25.24 |
| D1120 | Dental prophylaxis child | 163,603 | $47.41 | $0.00 | $719.00 |
| D0274 | Bitewings four images | 155,815 | $44.50 | $0.00 | $419.42 |
| H0040 | Assert comm tx pgm per diem | 148,306 | $247.07 | $0.00 | $559.05 |
| D1330 | Oral hygiene instructions | 142,395 | $36.02 | $0.00 | $524.27 |
| 90471 | Immunization admin | 137,711 | $15.14 | $0.00 | $719.00 |
| T4535 | Disposable liner/shield/pad | 135,817 | $51.94 | $0.00 | $136.66 |
| 71045 | X-ray exam chest 1 view | 133,221 | $6.26 | $0.00 | $147.73 |
| G0480 | Drug test def 1-7 classes | 131,641 | $60.33 | $0.00 | $143.52 |
| D0140 | Limit oral eval problm focus | 131,289 | $74.89 | $1.16 | $674.06 |
| 71046 | X-ray exam chest 2 views | 130,395 | $12.31 | $0.00 | $171.16 |
| T4541 | Large disposable underpad | 128,703 | $40.48 | $19.47 | $128.57 |
| 97155 | Adapt behavior tx phys/qhp | 126,431 | $67.32 | $0.00 | $380.79 |
| 96127 | Brief emotional/behav assmt | 125,478 | $5.92 | $0.00 | $55.32 |
| T1020 | Personal care ser per diem | 125,260 | $277.10 | $0.00 | $909.89 |
| G2211 | Complex e/m visit add on | 124,780 | $2.28 | $0.00 | $16.95 |
| 97110 | Therapeutic exercises | 124,292 | $33.51 | $0.00 | $493.54 |
| H2012 | Behav hlth day treat, per hr | 122,796 | $194.68 | $10.35 | $338.45 |
| H0019 | Alcohol and/or drug services | 112,187 | $501.98 | $279.58 | $5,513.64 |
| V2020 | Vision svcs frames purchases | 110,320 | $36.22 | $0.00 | $132.34 |
| 92014 | Compre oph exam est pt 1/> | 109,157 | $86.76 | $2.50 | $719.00 |
| 80053 | Comprehen metabolic panel | 103,147 | $17.04 | $0.00 | $1,422.69 |
| A4927 | Non-sterile gloves | 102,934 | $17.75 | $11.28 | $49.18 |
| S5165 | Home modifications per serv | 102,578 | $101.55 | $14.10 | $15,449.89 |
| D2392 | Post 2 srfc resinbased cmpst | 101,811 | $111.17 | $0.00 | $1,642.63 |
| D0330 | Panoramic image | 101,144 | $75.82 | $0.00 | $239.67 |
| 83655 | Assay of lead | 96,914 | $7.66 | $0.00 | $77.84 |
| H2019 | Ther behav svc, per 15 min | 96,256 | $92.02 | $26.94 | $272.19 |
| D1351 | Dental sealant per tooth | 93,614 | $38.76 | $0.00 | $210.13 |
| 92340 | Fit spectacles monofocal | 92,713 | $25.56 | $0.00 | $43.35 |
| D0150 | Comprehensve oral evaluation | 92,599 | $66.19 | $0.00 | $570.24 |
| 92551 | Pure tone hearing test air | 90,941 | $7.34 | $0.00 | $51.84 |
| V2784 | Lens polycarb or equal | 88,675 | $28.45 | $0.00 | $107.64 |
| S5161 | Emer rspns sys serv permonth | 87,875 | $46.35 | $0.00 | $75.60 |
| 80048 | Basic metabolic pnl total ca | 86,051 | $15.47 | $0.00 | $412.96 |
| A0427 | Als1-emergency | 85,718 | $626.19 | $0.00 | $1,934.61 |
| S5102 | Adult day care per diem | 85,140 | $91.05 | $25.71 | $191.75 |
| T4527 | Adult size pull-on lg | 83,632 | $93.67 | $43.76 | $361.06 |
| T2029 | Special med equip, noswaiver | 83,471 | $106.96 | $0.00 | $1,248.83 |
| D2991 | App of hydroxyapatite | 82,975 | $107.10 | $31.26 | $178.80 |
| 99173 | Visual acuity screen | 82,625 | $1.49 | $0.00 | $8.33 |
| D8670 | Periodic orthodontc tx visit | 81,893 | $233.78 | $0.00 | $308.71 |
| 90785 | Psytx complex interactive | 77,736 | $10.70 | $0.00 | $43.64 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 76,352 | $64.56 | $10.18 | $163.95 |
| D7140 | Extraction erupted tooth/exr | 74,398 | $121.04 | $0.00 | $2,543.30 |
| D2391 | Post 1 srfc resinbased cmpst | 74,108 | $87.34 | $2.55 | $912.38 |
| 87651 | Strep a dna amp probe | 72,286 | $27.95 | $0.00 | $100.37 |
| 99215 | Office o/p est hi 40 min | 70,691 | $126.50 | $1.72 | $719.00 |
| 83036 | Hemoglobin glycosylated a1c | 70,369 | $9.93 | $0.00 | $56.40 |
| T4526 | Adult size pull-on med | 69,421 | $86.34 | $40.10 | $203.88 |