North Carolina Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in North Carolina, based on 2024 claims data.
2024 Overview
Procedures
2.8K
Total Claims
153.2M
Total Paid
$6.4B
Popular Services
Procedures
Showing 1–50 of 2,810 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99199 | Unlisted special svc px/rprt | 54,559,358 | $5.91 | $0.00 | $816.11 |
| 99509 | Home visit day life activity | 7,772,938 | $63.87 | $0.00 | $2,425.32 |
| 99214 | Office o/p est mod 30 min | 3,219,100 | $62.08 | $0.00 | $719.00 |
| 99213 | Office o/p est low 20 min | 2,738,979 | $48.53 | $0.00 | $719.00 |
| 85025 | Complete cbc w/auto diff wbc | 1,878,936 | $5.20 | $0.00 | $813.57 |
| 80053 | Comprehen metabolic panel | 1,833,104 | $6.43 | $0.00 | $539.25 |
| 92507 | Tx sp lang voice comm indiv | 1,582,790 | $61.27 | $0.00 | $150.00 |
| 36415 | Coll venous bld venipuncture | 1,545,691 | $2.10 | $0.00 | $1,317.76 |
| S5125 | Attendant care service /15m | 1,369,852 | $137.01 | $17.02 | $225.32 |
| T2013 | Habil ed waiver per hour | 1,265,540 | $172.84 | $0.00 | $277.83 |
| 80061 | Lipid panel | 1,153,234 | $6.31 | $0.00 | $33.26 |
| T2012 | Habil ed waiver, per diem | 1,116,190 | $203.35 | $0.00 | $317.27 |
| T2021 | Day habil waiver per 15 min | 1,081,443 | $152.49 | $9.53 | $462.95 |
| D0120 | Periodic oral evaluation | 1,080,537 | $27.05 | $0.00 | $719.00 |
| 99284 | Emergency dept visit mod mdm | 1,065,339 | $155.85 | $0.00 | $916.22 |
| 90837 | Psytx w pt 60 minutes | 997,624 | $90.22 | $0.00 | $155.82 |
| 83036 | Hemoglobin glycosylated a1c | 994,240 | $4.59 | $0.00 | $18.00 |
| 97530 | Therapeutic activities | 931,695 | $70.46 | $0.00 | $153.75 |
| 80307 | Drug test prsmv chem anlyzr | 924,815 | $39.08 | $0.00 | $142.34 |
| T1015 | Clinic service | 886,362 | $140.34 | $0.00 | $1,037.53 |
| H2015 | Comp comm supp svc, 15 min | 870,103 | $166.14 | $0.00 | $542.44 |
| 87491 | Chlmyd trach dna amp probe | 860,714 | $18.56 | $0.00 | $69.08 |
| D1206 | Topical fluoride varnish | 859,755 | $14.91 | $0.00 | $265.18 |
| 87591 | N.gonorrhoeae dna amp prob | 855,958 | $17.64 | $0.00 | $56.11 |
| 84443 | Assay thyroid stim hormone | 798,608 | $6.93 | $0.00 | $31.72 |
| D1120 | Dental prophylaxis child | 773,892 | $25.71 | $0.00 | $391.29 |
| D0230 | Intraoral periapical ea add | 746,490 | $10.82 | $0.00 | $241.78 |
| 97153 | Adaptive behavior tx by tech | 693,791 | $348.38 | $0.00 | $564.79 |
| D0220 | Intraoral periapical first | 635,333 | $13.81 | $0.00 | $311.64 |
| 82306 | Vitamin d 25 hydroxy | 622,728 | $12.90 | $0.00 | $54.64 |
| 99283 | Emergency dept visit low mdm | 609,379 | $195.21 | $0.00 | $719.00 |
| H0020 | Alcohol and/or drug services | 608,772 | $221.76 | $0.00 | $718.40 |
| H0038 | Self-help/peer svc per 15min | 602,369 | $124.04 | $0.00 | $1,078.02 |
| 99285 | Emergency dept visit hi mdm | 558,423 | $160.95 | $0.00 | $1,739.58 |
| T1017 | Targeted case management | 549,703 | $255.31 | $0.00 | $433.05 |
| A4927 | Non-sterile gloves | 540,166 | $24.26 | $0.00 | $141.05 |
| 96127 | Brief emotional/behav assmt | 531,875 | $4.20 | $0.00 | $92.48 |
| 87661 | Trichomonas vaginalis amplif | 524,773 | $15.00 | $0.00 | $43.68 |
| 3074F | Syst bp lt 130 mm hg | 517,425 | $0.01 | $0.00 | $13.03 |
| 81001 | Urinalysis auto w/scope | 508,054 | $2.38 | $0.00 | $34.11 |
| H2017 | Psysoc rehab svc, per 15 min | 498,758 | $87.50 | $6.03 | $480.42 |
| 87389 | Hiv-1 ag w/hiv-1&-2 ab ag ia | 480,361 | $12.88 | $0.00 | $49.90 |
| D1110 | Dental prophylaxis adult | 472,401 | $35.07 | $0.00 | $65.22 |
| 90999 | Unlisted dialysis procedure | 464,568 | $36.01 | $0.00 | $214.56 |
| 87086 | Urine culture/colony count | 460,032 | $4.87 | $0.00 | $83.17 |
| 87798 | Detect agent nos dna amp | 457,709 | $26.96 | $0.00 | $346.06 |
| H2016 | Comp comm supp svc, per diem | 453,495 | $253.00 | $0.00 | $3,490.33 |
| 3078F | Diast bp <80 mm hg | 451,663 | $0.01 | $0.00 | $13.03 |
| A4554 | Disposable underpads | 445,014 | $41.29 | $0.00 | $76.08 |
| 3008F | Body mass index docd | 441,203 | $0.00 | $0.00 | $8.47 |