Montana Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Montana, based on 2024 claims data.
2024 Overview
Procedures
1.1K
Total Claims
10.6M
Total Paid
$955.6M
Popular Services
Procedures
Showing 1–50 of 1,145 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| S5126 | Attendant care service /diem | 4,046,872 | $111.04 | $28.40 | $207.45 |
| S5150 | Unskilled respite care /15m | 705,635 | $84.43 | $79.65 | $190.84 |
| T1019 | Personal care ser per 15 min | 376,082 | $91.89 | $16.90 | $1,463.75 |
| 90837 | Psytx w pt 60 minutes | 274,354 | $81.27 | $0.00 | $261.76 |
| 99213 | Office o/p est low 20 min | 216,986 | $53.85 | $0.00 | $134.31 |
| 99214 | Office o/p est mod 30 min | 205,322 | $82.61 | $0.00 | $189.40 |
| T1016 | Case management | 186,732 | $53.58 | $0.00 | $376.51 |
| S5136 | Adult companioncare per diem | 170,545 | $96.85 | $94.85 | $98.96 |
| 36415 | Coll venous bld venipuncture | 133,175 | $1.42 | $0.00 | $9.06 |
| 85025 | Complete cbc w/auto diff wbc | 124,931 | $0.97 | $0.00 | $13.28 |
| 80053 | Comprehen metabolic panel | 113,618 | $1.42 | $0.00 | $20.02 |
| 97530 | Therapeutic activities | 100,857 | $62.44 | $0.00 | $162.13 |
| 92507 | Tx sp lang voice comm indiv | 98,122 | $42.18 | $0.00 | $100.70 |
| D1206 | Topical fluoride varnish | 94,844 | $20.38 | $0.00 | $42.66 |
| H0036 | Comm psy face-face per 15min | 94,696 | $93.87 | $0.00 | $126.08 |
| D0120 | Periodic oral evaluation | 86,891 | $24.36 | $0.00 | $46.43 |
| 99283 | Emergency dept visit low mdm | 66,529 | $38.13 | $0.00 | $173.43 |
| 99284 | Emergency dept visit mod mdm | 63,548 | $71.39 | $0.00 | $158.40 |
| D1120 | Dental prophylaxis child | 61,266 | $34.80 | $0.00 | $80.60 |
| 97110 | Therapeutic exercises | 57,869 | $12.99 | $0.00 | $79.14 |
| H2012 | Behav hlth day treat, per hr | 57,098 | $73.10 | $14.98 | $414.49 |
| H2019 | Ther behav svc, per 15 min | 53,757 | $56.22 | $5.31 | $835.60 |
| H2020 | Ther behav svc, per diem | 50,329 | $187.00 | $0.00 | $536.91 |
| 99212 | Office o/p est sf 10 min | 49,799 | $2.78 | $0.00 | $74.69 |
| 90853 | Group psychotherapy | 43,838 | $11.69 | $0.00 | $18.78 |
| 99285 | Emergency dept visit hi mdm | 40,406 | $108.92 | $0.00 | $230.46 |
| 84443 | Assay thyroid stim hormone | 39,690 | $1.95 | $0.00 | $17.75 |
| D0603 | Caries risk assess high risk | 39,348 | $10.11 | $0.00 | $23.79 |
| J3490 | Drugs unclassified injection | 37,829 | $1.09 | $0.00 | $55.56 |
| D1110 | Dental prophylaxis adult | 37,689 | $44.78 | $0.00 | $78.10 |
| 92015 | Determine refractive state | 35,348 | $15.68 | $0.00 | $25.26 |
| G0463 | Hospital outpt clinic visit | 34,818 | $0.03 | $0.00 | $2.48 |
| 92508 | Tx sp lang voice comm group | 34,081 | $10.56 | $0.00 | $12.45 |
| 90832 | Psytx w pt 30 minutes | 33,542 | $16.78 | $0.00 | $91.54 |
| 81001 | Urinalysis auto w/scope | 31,980 | $0.65 | $0.00 | $5.68 |
| S5145 | Child fostercare th per diem | 31,959 | $274.48 | $168.12 | $3,838.73 |
| 80061 | Lipid panel | 31,705 | $1.73 | $0.00 | $13.45 |
| 83036 | Hemoglobin glycosylated a1c | 31,218 | $1.52 | $0.00 | $12.30 |
| 90834 | Psytx w pt 45 minutes | 30,894 | $28.05 | $0.00 | $79.73 |
| D1351 | Dental sealant per tooth | 30,289 | $26.11 | $0.00 | $52.46 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or | 29,238 | $70.98 | $0.00 | $154.88 |
| D0272 | Dental bitewings two images | 28,432 | $22.50 | $0.00 | $63.91 |
| G2211 | Complex e/m visit add on | 26,547 | $15.08 | $0.00 | $21.72 |
| 97112 | Neuromuscular reeducation | 26,227 | $27.35 | $0.00 | $100.49 |
| 71045 | X-ray exam chest 1 view | 25,884 | $5.25 | $0.00 | $36.36 |
| 93010 | Electrocardiogram report | 25,308 | $7.54 | $0.00 | $12.41 |
| 96374 | Ther/proph/diag inj iv push | 24,600 | $2.75 | $0.00 | $28.77 |
| 93005 | Electrocardiogram tracing | 23,721 | $1.23 | $0.00 | $29.76 |
| D0140 | Limit oral eval problm focus | 23,680 | $18.93 | $0.00 | $54.85 |
| 97140 | Manual therapy 1/> regions | 23,624 | $10.73 | $0.00 | $69.50 |