New Jersey Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in New Jersey, based on 2024 claims data.
2024 Overview
Procedures
3.4K
Total Claims
112.8M
Total Paid
$7.4B
Popular Services
Procedures
Showing 1–50 of 3,387 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| T1019 | Personal care ser per 15 min | 6,467,843 | $118.61 | $2.09 | $248.13 |
| S5102 | Adult day care per diem | 3,491,835 | $88.10 | $0.00 | $443.80 |
| 99213 | Office o/p est low 20 min | 3,115,436 | $48.43 | $0.00 | $338.26 |
| H2016 | Comp comm supp svc, per diem | 2,928,397 | $561.35 | $143.05 | $46,115.15 |
| 85025 | Complete cbc w/auto diff wbc | 2,785,928 | $2.33 | $0.00 | $16.95 |
| 80053 | Comprehen metabolic panel | 2,511,887 | $5.00 | $0.00 | $98.91 |
| 36415 | Coll venous bld venipuncture | 2,099,114 | $0.96 | $0.00 | $28.99 |
| 99214 | Office o/p est mod 30 min | 2,046,977 | $67.46 | $0.00 | $500.00 |
| 80061 | Lipid panel | 1,945,317 | $4.68 | $0.00 | $44.06 |
| T2021 | Day habil waiver per 15 min | 1,751,661 | $220.79 | $70.16 | $14,340.57 |
| 83036 | Hemoglobin glycosylated a1c | 1,704,582 | $3.42 | $0.00 | $24.96 |
| T1018 | School-based iep ser bundled | 1,479,223 | $139.71 | $30.99 | $299.43 |
| 84443 | Assay thyroid stim hormone | 1,261,349 | $4.81 | $0.00 | $27.03 |
| 81001 | Urinalysis auto w/scope | 1,168,840 | $1.57 | $0.00 | $23.95 |
| 87491 | Chlmyd trach dna amp probe | 1,048,118 | $15.48 | $0.00 | $74.35 |
| 87591 | N.gonorrhoeae dna amp prob | 1,039,259 | $14.59 | $0.00 | $90.40 |
| 82306 | Vitamin d 25 hydroxy | 1,025,756 | $11.19 | $0.00 | $52.79 |
| 80307 | Drug test prsmv chem anlyzr | 1,022,649 | $29.24 | $0.00 | $62.93 |
| A0425 | Ground mileage | 977,042 | $7.52 | $0.00 | $65.87 |
| 97110 | Therapeutic exercises | 904,818 | $16.26 | $0.00 | $225.11 |
| 99284 | Emergency dept visit mod mdm | 861,197 | $227.98 | $0.00 | $718.06 |
| 90834 | Psytx w pt 45 minutes | 849,890 | $92.45 | $0.00 | $383.82 |
| H0035 | Mh partial hosp tx under 24h | 757,063 | $104.68 | $0.00 | $378.86 |
| A0090 | Interest escort in non er | 680,990 | $12.44 | $0.00 | $822.16 |
| 84439 | Assay of free thyroxine | 675,081 | $3.63 | $0.00 | $22.20 |
| D0120 | Periodic oral evaluation | 651,717 | $24.95 | $0.00 | $228.86 |
| 87389 | Hiv-1 ag w/hiv-1&-2 ab ag ia | 632,385 | $10.70 | $0.00 | $51.92 |
| 87086 | Urine culture/colony count | 609,494 | $3.41 | $0.00 | $63.18 |
| D1351 | Dental sealant per tooth | 585,411 | $22.81 | $0.00 | $117.60 |
| D0230 | Intraoral periapical ea add | 581,457 | $3.14 | $0.00 | $32.25 |
| 87661 | Trichomonas vaginalis amplif | 573,044 | $11.67 | $0.00 | $107.29 |
| 82607 | Vitamin b-12 | 571,753 | $6.07 | $0.00 | $24.33 |
| 99285 | Emergency dept visit hi mdm | 539,675 | $257.06 | $0.00 | $1,105.09 |
| 86592 | Syphilis test non-trep qual | 533,395 | $1.90 | $0.00 | $8.20 |
| 86803 | Hepatitis c ab test | 531,226 | $6.45 | $0.00 | $23.94 |
| H2021 | Com wrap-around sv, 15 min | 530,232 | $287.63 | $32.35 | $15,473.07 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 528,970 | $28.30 | $0.00 | $289.38 |
| 83540 | Assay of iron | 521,066 | $2.27 | $0.00 | $10.38 |
| D0220 | Intraoral periapical first | 506,485 | $4.88 | $0.00 | $18.58 |
| 80048 | Basic metabolic pnl total ca | 504,457 | $2.96 | $0.00 | $68.23 |
| 80050 | General health panel | 484,185 | $21.20 | $0.00 | $41.15 |
| 97530 | Therapeutic activities | 478,154 | $29.05 | $0.00 | $220.93 |
| H0036 | Comm psy face-face per 15min | 475,045 | $228.83 | $0.00 | $512.51 |
| 99283 | Emergency dept visit low mdm | 472,781 | $271.23 | $0.00 | $537.84 |
| 87340 | Hepatitis b surface ag ia | 465,739 | $4.97 | $0.00 | $17.89 |
| 97140 | Manual therapy 1/> regions | 462,576 | $16.59 | $0.00 | $109.51 |
| 87798 | Detect agent nos dna amp | 460,088 | $27.04 | $0.00 | $273.22 |
| 82570 | Assay of urine creatinine | 452,656 | $2.06 | $0.00 | $12.61 |
| 82728 | Assay of ferritin | 445,927 | $5.14 | $0.00 | $21.72 |
| H0019 | Alcohol and/or drug services | 436,737 | $269.66 | $1.25 | $8,766.33 |