New Hampshire Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in New Hampshire, based on 2024 claims data.
2024 Overview
Procedures
906
Total Claims
5.5M
Total Paid
$905.6M
Popular Services
Procedures
Showing 1–50 of 906 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| T1020 | Personal care ser per diem | 437,753 | $503.23 | $156.78 | $25,771.49 |
| T1019 | Personal care ser per 15 min | 354,516 | $195.66 | $0.00 | $2,000.50 |
| T2021 | Day habil waiver per 15 min | 324,085 | $262.48 | $63.17 | $3,332.06 |
| 99214 | Office o/p est mod 30 min | 214,659 | $58.74 | $0.00 | $382.91 |
| 99213 | Office o/p est low 20 min | 182,771 | $38.42 | $0.00 | $375.92 |
| H2019 | Ther behav svc, per 15 min | 177,295 | $104.18 | $6.97 | $170.01 |
| T1016 | Case management | 160,982 | $343.58 | $0.00 | $425.57 |
| 90837 | Psytx w pt 60 minutes | 113,437 | $107.37 | $0.00 | $266.84 |
| T1015 | Clinic service | 106,735 | $242.58 | $0.00 | $484.13 |
| H2017 | Psysoc rehab svc, per 15 min | 103,329 | $20.75 | $6.48 | $55.09 |
| G2067 | Med assist tx meth wk | 99,625 | $112.29 | $4.59 | $141.95 |
| 97530 | Therapeutic activities | 87,529 | $38.92 | $0.00 | $123.86 |
| S5140 | Adult foster care per diem | 84,149 | $394.92 | $27.79 | $1,128.96 |
| 90834 | Psytx w pt 45 minutes | 81,909 | $73.79 | $0.00 | $100.58 |
| 92508 | Tx sp lang voice comm group | 68,030 | $2.46 | $0.00 | $11.43 |
| D0120 | Periodic oral evaluation | 67,660 | $35.05 | $0.00 | $39.75 |
| H2036 | A/d tx program, per diem | 65,281 | $287.77 | $190.14 | $321.89 |
| G0156 | Hhcp-svs of aide,ea 15 min | 61,659 | $217.11 | $0.00 | $291.55 |
| 92507 | Tx sp lang voice comm indiv | 58,505 | $70.43 | $0.00 | $249.03 |
| T2022 | Case management, per month | 57,486 | $264.20 | $43.73 | $417.04 |
| D1120 | Dental prophylaxis child | 57,415 | $39.20 | $0.00 | $57.00 |
| H2022 | Com wrap-around sv, per diem | 57,178 | $310.84 | $89.52 | $2,943.67 |
| D1206 | Topical fluoride varnish | 54,932 | $22.37 | $0.00 | $34.63 |
| T1030 | Rn home care per diem | 52,759 | $109.09 | $0.00 | $129.00 |
| 99284 | Emergency dept visit mod mdm | 51,641 | $105.03 | $0.00 | $652.08 |
| 97110 | Therapeutic exercises | 47,824 | $40.70 | $0.00 | $144.07 |
| H2023 | Supported employ, per 15 min | 46,773 | $155.97 | $15.73 | $853.74 |
| D1354 | Int caries med app per tooth | 46,659 | $28.84 | $0.00 | $37.88 |
| 93010 | Electrocardiogram report | 38,268 | $4.84 | $0.00 | $12.29 |
| 99285 | Emergency dept visit hi mdm | 36,463 | $112.12 | $0.00 | $850.79 |
| 85025 | Complete cbc w/auto diff wbc | 36,122 | $3.26 | $0.00 | $68.61 |
| 80053 | Comprehen metabolic panel | 34,556 | $5.76 | $0.00 | $134.64 |
| D1351 | Dental sealant per tooth | 33,414 | $29.01 | $0.00 | $159.47 |
| H2015 | Comp comm supp svc, 15 min | 33,412 | $128.39 | $36.87 | $3,454.65 |
| G0463 | Hospital outpt clinic visit | 32,867 | $5.02 | $0.00 | $111.84 |
| H2020 | Ther behav svc, per diem | 31,171 | $210.88 | $59.80 | $273.21 |
| T1005 | Respite care service 15 min | 31,009 | $179.59 | $68.92 | $1,317.21 |
| 99283 | Emergency dept visit low mdm | 29,757 | $135.16 | $0.00 | $433.28 |
| 36415 | Coll venous bld venipuncture | 29,690 | $0.75 | $0.00 | $24.24 |
| 90832 | Psytx w pt 30 minutes | 29,373 | $41.64 | $0.00 | $366.78 |
| H0038 | Self-help/peer svc per 15min | 27,566 | $65.92 | $0.00 | $250.87 |
| H0018 | Alcohol and/or drug services | 26,197 | $257.07 | $24.20 | $500.47 |
| D1110 | Dental prophylaxis adult | 25,615 | $61.79 | $0.00 | $75.00 |
| H0034 | Med trng & support per 15min | 25,111 | $31.32 | $9.08 | $42.57 |
| 71046 | X-ray exam chest 2 views | 25,041 | $10.93 | $0.00 | $128.57 |
| 92015 | Determine refractive state | 24,938 | $19.49 | $0.00 | $27.39 |
| D1208 | Topical app fluorid ex vrnsh | 24,472 | $20.98 | $0.00 | $27.30 |
| T1024 | Team evaluation & management | 24,374 | $333.96 | $162.53 | $446.43 |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to | 24,152 | $25.54 | $13.37 | $256.34 |
| 71045 | X-ray exam chest 1 view | 21,883 | $3.65 | $0.00 | $118.37 |