New York Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in New York, based on 2024 claims data.
2024 Overview
Procedures
4.1K
Total Claims
258.0M
Total Paid
$25.2B
Popular Services
Procedures
Showing 1–50 of 4,071 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| T1019 | Personal care ser per 15 min | 91,363,894 | $160.58 | $0.00 | $1,011.75 |
| 99213 | Office o/p est low 20 min | 11,185,928 | $76.17 | $0.00 | $719.00 |
| 99214 | Office o/p est mod 30 min | 5,338,021 | $88.73 | $0.00 | $719.00 |
| S5105 | Centerbased day care perdiem | 4,665,987 | $78.94 | $0.54 | $130.16 |
| 36415 | Coll venous bld venipuncture | 3,434,429 | $8.38 | $0.00 | $332.30 |
| S5126 | Attendant care service /diem | 2,874,893 | $111.59 | $109.23 | $330.67 |
| 97110 | Therapeutic exercises | 2,281,654 | $40.82 | $0.00 | $290.71 |
| D0120 | Periodic oral evaluation | 1,892,631 | $26.23 | $0.00 | $224.57 |
| 97530 | Therapeutic activities | 1,866,550 | $53.17 | $0.00 | $293.00 |
| S5102 | Adult day care per diem | 1,852,163 | $99.44 | $0.00 | $301.14 |
| 80053 | Comprehen metabolic panel | 1,761,033 | $14.20 | $0.00 | $699.03 |
| 90834 | Psytx w pt 45 minutes | 1,685,400 | $125.19 | $0.00 | $719.00 |
| 85025 | Complete cbc w/auto diff wbc | 1,681,333 | $2.64 | $0.00 | $179.75 |
| H0020 | Alcohol and/or drug services | 1,633,007 | $29.69 | $0.00 | $174.40 |
| 90832 | Psytx w pt 30 minutes | 1,519,042 | $115.51 | $0.00 | $719.00 |
| T1020 | Personal care ser per diem | 1,467,854 | $354.79 | $0.00 | $448.01 |
| 99284 | Emergency dept visit mod mdm | 1,285,022 | $135.25 | $0.00 | $1,455.50 |
| 99212 | Office o/p est sf 10 min | 1,276,825 | $76.80 | $0.00 | $719.00 |
| D0220 | Intraoral periapical first | 1,266,741 | $11.10 | $0.00 | $113.60 |
| A0100 | Nonemergency transport taxi | 1,172,563 | $26.78 | $0.00 | $244.78 |
| G9005 | Mccd, risk adj, maintenance | 1,166,554 | $298.13 | $253.43 | $402.15 |
| D1110 | Dental prophylaxis adult | 1,154,550 | $44.81 | $0.00 | $208.21 |
| 97140 | Manual therapy 1/> regions | 1,124,837 | $17.65 | $0.00 | $719.00 |
| 90460 | Im admin 1st/only component | 1,050,989 | $26.18 | $0.00 | $616.57 |
| D0230 | Intraoral periapical ea add | 1,026,649 | $8.57 | $0.00 | $94.20 |
| A0130 | Noner transport wheelch van | 1,007,569 | $30.32 | $0.00 | $566.47 |
| 92507 | Tx sp lang voice comm indiv | 1,002,816 | $79.06 | $0.00 | $268.39 |
| T2003 | N-et; encounter/trip | 1,002,806 | $26.56 | $0.00 | $88.63 |
| 99283 | Emergency dept visit low mdm | 987,605 | $158.15 | $0.00 | $1,000.64 |
| 93010 | Electrocardiogram report | 975,267 | $5.66 | $0.00 | $17.11 |
| T1017 | Targeted case management | 969,491 | $33.44 | $1.15 | $562.00 |
| D1120 | Dental prophylaxis child | 949,489 | $39.13 | $0.00 | $147.74 |
| 97112 | Neuromuscular reeducation | 938,127 | $27.08 | $0.00 | $171.01 |
| S5161 | Emer rspns sys serv permonth | 932,298 | $24.50 | $0.00 | $51.44 |
| 99203 | Office o/p new low 30 min | 860,377 | $102.39 | $0.00 | $387.45 |
| S5150 | Unskilled respite care /15m | 856,725 | $122.37 | $17.27 | $386.85 |
| 80061 | Lipid panel | 854,938 | $8.24 | $0.00 | $719.00 |
| 90837 | Psytx w pt 60 minutes | 793,017 | $109.44 | $0.00 | $719.00 |
| D0274 | Bitewings four images | 789,502 | $23.05 | $0.00 | $108.06 |
| A4554 | Disposable underpads | 783,859 | $42.46 | $14.79 | $95.15 |
| A0425 | Ground mileage | 782,530 | $17.61 | $0.00 | $459.16 |
| 83036 | Hemoglobin glycosylated a1c | 778,172 | $5.82 | $-1.45 | $120.32 |
| 3008F | Body mass index docd | 752,185 | $0.52 | $0.00 | $97.78 |
| T1040 | Comm bh clinic svc per diem | 727,334 | $129.11 | $0.00 | $253.27 |
| 3074F | Syst bp lt 130 mm hg | 717,536 | $0.65 | $0.00 | $40.53 |
| 3078F | Diast bp <80 mm hg | 704,526 | $0.45 | $0.00 | $24.58 |
| 71045 | X-ray exam chest 1 view | 699,867 | $5.40 | $0.00 | $93.19 |
| 99308 | Sbsq nf care low mdm 20 | 690,682 | $10.35 | $0.00 | $169.98 |
| H2021 | Com wrap-around sv, 15 min | 673,182 | $151.27 | $144.32 | $219.91 |
| 81001 | Urinalysis auto w/scope | 646,793 | $2.29 | $0.00 | $462.21 |