Texas Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Texas, based on 2024 claims data.
2024 Overview
Procedures
3.2K
Total Claims
200.0M
Total Paid
$11.7B
Popular Services
Procedures
Showing 1–50 of 3,181 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| S5125 | Attendant care service /15m | 55,437,527 | $62.85 | $0.00 | $917.35 |
| T1019 | Personal care ser per 15 min | 8,230,771 | $31.17 | $0.00 | $132.12 |
| 99213 | Office o/p est low 20 min | 6,404,354 | $42.64 | $0.00 | $420.11 |
| H2014 | Skills train and dev, 15 min | 3,938,362 | $71.92 | $0.00 | $831.58 |
| H2016 | Comp comm supp svc, per diem | 3,819,183 | $228.99 | $66.70 | $5,861.85 |
| D0230 | Intraoral periapical ea add | 3,595,258 | $9.92 | $0.00 | $53.15 |
| 99214 | Office o/p est mod 30 min | 3,358,705 | $52.27 | $0.00 | $576.00 |
| 92507 | Tx sp lang voice comm indiv | 3,185,409 | $88.27 | $0.00 | $255.82 |
| T1005 | Respite care service 15 min | 2,977,723 | $61.49 | $0.00 | $287.75 |
| 90460 | Im admin 1st/only component | 2,909,554 | $12.22 | $0.00 | $71.51 |
| D0603 | Caries risk assess high risk | 2,717,621 | $0.02 | $0.00 | $30.38 |
| T1015 | Clinic service | 2,471,110 | $180.71 | $0.00 | $719.00 |
| D0220 | Intraoral periapical first | 2,169,010 | $11.01 | $0.00 | $36.71 |
| D0120 | Periodic oral evaluation | 2,160,493 | $29.47 | $0.00 | $1,453.08 |
| D1351 | Dental sealant per tooth | 1,796,885 | $25.05 | $0.00 | $158.76 |
| D1208 | Topical app fluorid ex vrnsh | 1,789,603 | $13.77 | $0.00 | $28.76 |
| D1120 | Dental prophylaxis child | 1,742,371 | $33.78 | $0.00 | $153.21 |
| A0100 | Nonemergency transport taxi | 1,739,321 | $50.22 | $0.00 | $475.44 |
| 97530 | Therapeutic activities | 1,673,253 | $72.13 | $0.00 | $451.58 |
| T1000 | Private duty/independent nsg | 1,608,351 | $531.95 | $0.00 | $2,518.42 |
| 99284 | Emergency dept visit mod mdm | 1,517,395 | $169.18 | $0.00 | $6,368.94 |
| 85025 | Complete cbc w/auto diff wbc | 1,454,108 | $5.36 | $0.00 | $154.26 |
| 87804 | Influenza assay w/optic | 1,344,228 | $12.92 | $0.00 | $318.48 |
| 87880 | Strep a assay w/optic | 1,251,842 | $11.52 | $0.00 | $143.37 |
| T2003 | N-et; encounter/trip | 1,228,811 | $6.32 | $0.00 | $50.23 |
| S5101 | Adult day care per half day | 1,204,582 | $91.75 | $0.00 | $1,475.54 |
| T2016 | Habil res waiver per diem | 1,189,706 | $151.38 | $10.92 | $16,528.13 |
| 80053 | Comprehen metabolic panel | 1,040,613 | $8.80 | $0.00 | $587.97 |
| 97110 | Therapeutic exercises | 1,016,778 | $50.83 | $0.00 | $480.82 |
| A4335 | Incontinence supply | 1,014,499 | $4.46 | $0.00 | $16.84 |
| D0272 | Dental bitewings two images | 983,746 | $20.62 | $0.00 | $29.01 |
| 36415 | Coll venous bld venipuncture | 974,852 | $0.66 | $0.00 | $179.38 |
| D2392 | Post 2 srfc resinbased cmpst | 963,708 | $94.64 | $0.00 | $144.00 |
| 71045 | X-ray exam chest 1 view | 901,672 | $7.73 | $0.00 | $418.16 |
| 99283 | Emergency dept visit low mdm | 865,868 | $119.64 | $0.00 | $993.93 |
| T2026 | Special childcare waiver/d | 834,079 | $162.65 | $76.49 | $2,554.07 |
| A4554 | Disposable underpads | 815,134 | $26.14 | $0.00 | $299.79 |
| 96110 | Developmental screen w/score | 802,105 | $7.71 | $0.00 | $156.89 |
| D1206 | Topical fluoride varnish | 768,272 | $13.29 | $0.00 | $40.26 |
| 99392 | Prev visit est age 1-4 | 744,431 | $79.41 | $0.00 | $427.54 |
| D0274 | Bitewings four images | 737,197 | $29.64 | $0.00 | $83.32 |
| 80061 | Lipid panel | 720,745 | $7.17 | $0.00 | $428.64 |
| D1110 | Dental prophylaxis adult | 680,902 | $49.91 | $0.00 | $246.38 |
| 99212 | Office o/p est sf 10 min | 678,922 | $38.63 | $0.00 | $304.20 |
| 99391 | Per pm reeval est pat infant | 675,717 | $79.26 | $0.00 | $426.72 |
| 83036 | Hemoglobin glycosylated a1c | 654,073 | $5.06 | $0.00 | $150.93 |
| 3008F | Body mass index docd | 653,507 | $0.00 | $0.00 | $0.13 |
| 87798 | Detect agent nos dna amp | 609,682 | $40.20 | $0.00 | $324.34 |
| 87426 | Sarscov coronavirus ag ia | 603,048 | $33.78 | $0.00 | $203.99 |
| 81002 | Urinalysis nonauto w/o scope | 592,807 | $2.50 | $0.00 | $69.10 |