South Carolina Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in South Carolina, based on 2024 claims data.
2024 Overview
Procedures
1.9K
Total Claims
27.2M
Total Paid
$1.7B
Popular Services
Procedures
Showing 1–50 of 1,897 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99213 | Office o/p est low 20 min | 1,286,952 | $72.77 | $0.00 | $377.51 |
| T2016 | Habil res waiver per diem | 1,194,523 | $268.81 | $106.26 | $421.08 |
| 99214 | Office o/p est mod 30 min | 1,080,430 | $79.12 | $0.00 | $377.51 |
| T1019 | Personal care ser per 15 min | 955,162 | $106.96 | $0.00 | $157.65 |
| T1015 | Clinic service | 893,004 | $33.39 | $0.00 | $377.51 |
| T1502 | Medication admin visit | 595,546 | $8.82 | $0.00 | $14.40 |
| 97530 | Therapeutic activities | 465,799 | $70.02 | $0.00 | $139.64 |
| 92507 | Tx sp lang voice comm indiv | 465,542 | $76.46 | $0.00 | $159.50 |
| 99284 | Emergency dept visit mod mdm | 440,016 | $51.23 | $0.00 | $367.93 |
| T1017 | Targeted case management | 427,653 | $48.71 | $26.64 | $133.33 |
| T2020 | Day habil waiver per diem | 403,070 | $76.13 | $38.34 | $85.06 |
| 85025 | Complete cbc w/auto diff wbc | 376,134 | $2.04 | $0.00 | $4,453.70 |
| 99283 | Emergency dept visit low mdm | 375,692 | $40.82 | $0.00 | $300.94 |
| 36415 | Coll venous bld venipuncture | 373,818 | $49.00 | $0.00 | $963.19 |
| D1206 | Topical fluoride varnish | 370,878 | $17.36 | $0.00 | $25.86 |
| D0120 | Periodic oral evaluation | 365,807 | $25.23 | $0.00 | $100.00 |
| 90837 | Psytx w pt 60 minutes | 355,446 | $134.18 | $0.00 | $358.59 |
| 92508 | Tx sp lang voice comm group | 323,852 | $23.78 | $11.89 | $44.52 |
| 80053 | Comprehen metabolic panel | 305,629 | $50.02 | $0.00 | $510.31 |
| D1120 | Dental prophylaxis child | 302,776 | $35.99 | $0.00 | $637.08 |
| 97110 | Therapeutic exercises | 277,817 | $52.73 | $0.00 | $181.35 |
| 90460 | Im admin 1st/only component | 266,563 | $43.59 | $0.00 | $133.73 |
| T2014 | Habil prevoc waiver, per d | 244,624 | $76.07 | $38.34 | $83.26 |
| S5102 | Adult day care per diem | 233,406 | $67.93 | $33.83 | $87.38 |
| 71045 | X-ray exam chest 1 view | 198,253 | $6.56 | $0.00 | $110.47 |
| T5999 | Supply, nos | 198,089 | $10.05 | $2.14 | $18.71 |
| 87880 | Strep a assay w/optic | 194,797 | $16.85 | $0.00 | $132.32 |
| D1110 | Dental prophylaxis adult | 175,957 | $51.03 | $0.00 | $57.73 |
| T1016 | Case management | 174,046 | $55.73 | $0.00 | $147.28 |
| D0272 | Dental bitewings two images | 173,256 | $19.50 | $0.00 | $183.43 |
| 99285 | Emergency dept visit hi mdm | 172,236 | $43.13 | $0.00 | $419.58 |
| D0220 | Intraoral periapical first | 169,652 | $13.43 | $0.00 | $288.27 |
| H2026 | Supp maint employ, per diem | 159,217 | $77.17 | $38.34 | $83.26 |
| 81001 | Urinalysis auto w/scope | 154,157 | $14.44 | $0.00 | $144.19 |
| 87804 | Influenza assay w/optic | 153,060 | $14.65 | $0.00 | $107.06 |
| D0230 | Intraoral periapical ea add | 144,879 | $11.50 | $0.00 | $14.62 |
| A0425 | Ground mileage | 138,492 | $14.96 | $0.00 | $159.41 |
| T1002 | Rn services up to 15 minutes | 136,767 | $87.95 | $5.23 | $445.14 |
| D0274 | Bitewings four images | 127,887 | $28.46 | $0.00 | $40.29 |
| 93005 | Electrocardiogram tracing | 126,318 | $2.51 | $0.00 | $54.25 |
| 96372 | Ther/proph/diag inj sc/im | 124,004 | $64.09 | $0.00 | $2,539.65 |
| 99212 | Office o/p est sf 10 min | 120,017 | $54.94 | $0.00 | $782.38 |
| 81025 | Urine pregnancy test | 118,200 | $47.24 | $0.00 | $925.72 |
| 81003 | Urinalysis auto w/o scope | 117,457 | $12.22 | $0.00 | $165.38 |
| D1351 | Dental sealant per tooth | 116,288 | $31.44 | $0.00 | $1,314.13 |
| T1027 | Family training & counseling | 116,118 | $105.98 | $61.97 | $153.47 |
| D9230 | Analgesia | 112,405 | $32.70 | $0.00 | $43.08 |
| 80048 | Basic metabolic pnl total ca | 111,223 | $39.87 | $0.00 | $1,108.20 |
| 99391 | Per pm reeval est pat infant | 109,881 | $105.22 | $0.00 | $377.51 |
| 99199 | Unlisted special svc px/rprt | 109,438 | $4.66 | $0.65 | $13.58 |