South Dakota Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in South Dakota, based on 2024 claims data.
2024 Overview
Procedures
1.1K
Total Claims
3.9M
Total Paid
$498.7M
Popular Services
Procedures
Showing 1–50 of 1,069 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99213 | Office o/p est low 20 min | 257,030 | $167.24 | $0.00 | $719.00 |
| T2016 | Habil res waiver per diem | 170,716 | $752.90 | $219.72 | $10,683.01 |
| T2020 | Day habil waiver per diem | 159,257 | $188.38 | $47.63 | $1,653.42 |
| 99214 | Office o/p est mod 30 min | 148,239 | $108.39 | $0.00 | $704.90 |
| S5130 | Homaker service nos per 15m | 92,137 | $71.94 | $27.20 | $123.94 |
| T1019 | Personal care ser per 15 min | 82,043 | $81.90 | $28.09 | $211.16 |
| H2016 | Comp comm supp svc, per diem | 81,652 | $101.03 | $53.88 | $128.79 |
| T1016 | Case management | 73,030 | $66.30 | $18.25 | $274.03 |
| 36415 | Coll venous bld venipuncture | 70,197 | $31.46 | $0.00 | $1,329.50 |
| 90837 | Psytx w pt 60 minutes | 68,539 | $107.20 | $13.48 | $719.00 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 54,564 | $46.39 | $16.76 | $67.88 |
| H2021 | Com wrap-around sv, 15 min | 51,925 | $120.33 | $70.26 | $212.50 |
| 98941 | Chiropract manj 3-4 regions | 49,257 | $27.47 | $3.80 | $36.27 |
| T2025 | Waiver service, nos | 48,907 | $302.91 | $103.12 | $5,020.22 |
| D0120 | Periodic oral evaluation | 42,508 | $42.38 | $0.00 | $258.84 |
| 92507 | Tx sp lang voice comm indiv | 42,372 | $22.23 | $3.08 | $265.65 |
| G0463 | Hospital outpt clinic visit | 40,901 | $17.19 | $0.00 | $182.75 |
| D1351 | Dental sealant per tooth | 40,322 | $40.97 | $10.30 | $164.12 |
| 85025 | Complete cbc w/auto diff wbc | 40,116 | $6.52 | $0.00 | $299.58 |
| D1206 | Topical fluoride varnish | 40,037 | $49.08 | $0.00 | $719.00 |
| 99284 | Emergency dept visit mod mdm | 38,227 | $72.85 | $0.00 | $215.62 |
| 92015 | Determine refractive state | 34,719 | $11.93 | $0.00 | $68.48 |
| 90471 | Immunization admin | 34,150 | $46.11 | $0.00 | $719.00 |
| 97110 | Therapeutic exercises | 33,265 | $26.48 | $6.84 | $719.00 |
| S5135 | Adult companioncare per 15m | 31,786 | $110.52 | $68.05 | $198.85 |
| 80053 | Comprehen metabolic panel | 31,063 | $19.26 | $0.00 | $845.98 |
| H0039 | Asser com tx face-face/15min | 30,859 | $103.32 | $76.91 | $115.94 |
| T2019 | Habil sup empl waiver 15min | 30,664 | $89.61 | $16.66 | $803.13 |
| 97530 | Therapeutic activities | 29,802 | $40.82 | $5.66 | $216.85 |
| D1120 | Dental prophylaxis child | 29,219 | $49.84 | $0.00 | $465.24 |
| T1000 | Private duty/independent nsg | 29,018 | $110.09 | $9.91 | $389.21 |
| S5125 | Attendant care service /15m | 28,061 | $187.76 | $69.87 | $231.26 |
| 90999 | Unlisted dialysis procedure | 27,372 | $95.63 | $7.65 | $520.50 |
| V2020 | Vision svcs frames purchases | 27,162 | $61.60 | $9.62 | $77.50 |
| 90832 | Psytx w pt 30 minutes | 25,684 | $97.86 | $18.30 | $719.00 |
| 99285 | Emergency dept visit hi mdm | 25,166 | $110.58 | $0.00 | $163.30 |
| A9270 | Non-covered item or service | 23,787 | $23.76 | $0.00 | $569.18 |
| J3490 | Drugs unclassified injection | 23,494 | $185.21 | $0.00 | $1,371.77 |
| 99283 | Emergency dept visit low mdm | 22,975 | $65.75 | $0.00 | $336.49 |
| T1020 | Personal care ser per diem | 22,304 | $83.72 | $54.06 | $109.01 |
| A0425 | Ground mileage | 21,135 | $50.51 | $3.10 | $393.03 |
| V2199 | Lens single vision not oth c | 20,269 | $64.93 | $14.11 | $216.38 |
| 71045 | X-ray exam chest 1 view | 20,263 | $7.90 | $0.00 | $111.32 |
| 97112 | Neuromuscular reeducation | 19,893 | $25.50 | $7.02 | $70.16 |
| 93010 | Electrocardiogram report | 19,299 | $5.89 | $0.92 | $44.13 |
| T1002 | Rn services up to 15 minutes | 19,193 | $17.95 | $6.86 | $475.79 |
| 99203 | Office o/p new low 30 min | 18,946 | $67.17 | $3.34 | $198.36 |
| 92014 | Compre oph exam est pt 1/> | 18,666 | $108.45 | $1.66 | $719.00 |
| 87651 | Strep a dna amp probe | 18,510 | $30.79 | $0.00 | $156.02 |
| G2211 | Complex e/m visit add on | 18,496 | $1.75 | $0.00 | $10.88 |