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 51–100 of 906 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| S5170 | Homedelivered prepared meal | 21,880 | $30.85 | $13.79 | $63.81 |
| 97140 | Manual therapy 1/> regions | 21,658 | $38.02 | $0.00 | $87.24 |
| A0425 | Ground mileage | 21,483 | $56.96 | $2.50 | $632.35 |
| 80307 | Drug test prsmv chem anlyzr | 21,202 | $44.62 | $0.00 | $90.43 |
| T1027 | Family training & counseling | 21,002 | $104.23 | $0.00 | $640.68 |
| H0015 | Alcohol and/or drug services | 20,448 | $137.82 | $90.60 | $149.84 |
| 99309 | Sbsq nf care moderate mdm 30 | 20,331 | $6.07 | $0.00 | $109.39 |
| T2023 | Targeted case mgmt per month | 19,257 | $251.86 | $132.36 | $301.49 |
| 97112 | Neuromuscular reeducation | 19,234 | $47.58 | $0.00 | $100.85 |
| S9123 | Nursing care in home rn | 18,458 | $579.19 | $381.37 | $764.60 |
| D0274 | Bitewings four images | 18,278 | $37.76 | $0.00 | $49.49 |
| D2392 | Post 2 srfc resinbased cmpst | 17,931 | $125.46 | $60.11 | $163.22 |
| D0272 | Dental bitewings two images | 17,269 | $30.15 | $0.00 | $35.97 |
| 3008F | Body mass index docd | 16,798 | $0.00 | $0.00 | $0.00 |
| 90847 | Family psytx w/pt 50 min | 16,237 | $113.23 | $61.36 | $122.71 |
| S9124 | Nursing care, in the home; b | 15,892 | $369.25 | $227.23 | $510.33 |
| 90471 | Immunization admin | 15,683 | $5.96 | $0.00 | $72.58 |
| D9230 | Analgesia | 15,241 | $45.29 | $19.63 | $63.75 |
| 99215 | Office o/p est hi 40 min | 14,665 | $82.84 | $0.00 | $404.85 |
| 90853 | Group psychotherapy | 14,398 | $51.57 | $1.70 | $192.55 |
| 3074F | Syst bp lt 130 mm hg | 14,367 | $1.12 | $0.00 | $6.43 |
| G2211 | Complex e/m visit add on | 13,724 | $4.61 | $0.00 | $25.95 |
| G2078 | Take-home meth | 13,522 | $36.17 | $0.00 | $61.27 |
| D0150 | Comprehensve oral evaluation | 13,398 | $67.00 | $0.00 | $97.50 |
| T2003 | N-et; encounter/trip | 13,354 | $30.44 | $1.27 | $109.19 |
| T2025 | Waiver service, nos | 13,160 | $658.97 | $82.24 | $2,164.47 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 13,047 | $19.24 | $0.22 | $72.65 |
| 90460 | Im admin 1st/only component | 12,941 | $3.50 | $0.00 | $23.99 |
| H0005 | Alcohol and/or drug services | 12,932 | $21.57 | $0.00 | $194.33 |
| V2020 | Vision svcs frames purchases | 12,836 | $22.08 | $4.48 | $32.25 |
| 3078F | Diast bp <80 mm hg | 12,232 | $1.21 | $0.00 | $6.95 |
| V2784 | Lens polycarb or equal | 12,218 | $6.93 | $2.50 | $17.06 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or | 12,111 | $58.02 | $0.00 | $150.28 |
| T2017 | Habil res waiver 15 min | 11,806 | $345.51 | $91.91 | $6,104.33 |
| D0220 | Intraoral periapical first | 11,658 | $14.61 | $0.00 | $21.72 |
| 99308 | Sbsq nf care low mdm 20 | 11,495 | $5.75 | $0.00 | $77.10 |
| 92014 | Compre oph exam est pt 1/> | 11,400 | $56.34 | $0.00 | $106.59 |
| H0004 | Alcohol and/or drug services | 11,198 | $130.43 | $0.00 | $170.84 |
| D2391 | Post 1 srfc resinbased cmpst | 11,140 | $110.25 | $63.55 | $123.51 |
| 93005 | Electrocardiogram tracing | 11,082 | $17.24 | $0.00 | $141.39 |
| H0019 | Alcohol and/or drug services | 10,901 | $3,333.78 | $0.00 | $13,848.25 |
| T2033 | Res, nos waiver per diem | 10,813 | $999.78 | $380.71 | $6,364.12 |
| 88305 | Tissue exam by pathologist | 10,680 | $27.93 | $0.00 | $137.76 |
| 70450 | Ct head/brain w/o dye | 10,521 | $35.34 | $0.00 | $1,104.06 |
| 74177 | Ct abd & pelvis w/contrast | 10,195 | $60.48 | $0.00 | $726.91 |
| T2016 | Habil res waiver per diem | 9,277 | $489.01 | $483.22 | $492.09 |
| 96372 | Ther/proph/diag inj sc/im | 9,268 | $7.03 | $0.00 | $53.54 |
| 87880 | Strep a assay w/optic | 9,117 | $7.32 | $0.00 | $60.19 |
| H2014 | Skills train and dev, 15 min | 8,877 | $77.09 | $12.22 | $643.27 |
| H0010 | Alcohol and/or drug services | 8,761 | $536.37 | $160.85 | $641.66 |