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 51–100 of 3,181 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99393 | Prev visit est age 5-11 | 577,267 | $82.32 | $0.00 | $387.98 |
| T2017 | Habil res waiver 15 min | 564,395 | $84.65 | $22.75 | $140.21 |
| 90461 | Im admin each addl component | 561,899 | $0.51 | $0.00 | $47.50 |
| 92508 | Tx sp lang voice comm group | 541,724 | $3.64 | $0.00 | $57.33 |
| 87491 | Chlmyd trach dna amp probe | 532,183 | $20.05 | $0.00 | $102.84 |
| T1017 | Targeted case management | 529,830 | $110.09 | $0.00 | $750.00 |
| D0145 | Oral evaluation, pt < 3yrs | 529,688 | $129.94 | $0.00 | $142.07 |
| 87591 | N.gonorrhoeae dna amp prob | 515,817 | $19.96 | $0.00 | $166.62 |
| D2391 | Post 1 srfc resinbased cmpst | 512,369 | $73.32 | $0.00 | $110.00 |
| 90471 | Immunization admin | 510,269 | $8.99 | $0.00 | $152.39 |
| A0425 | Ground mileage | 487,434 | $56.10 | $0.00 | $1,108.09 |
| D9230 | Analgesia | 486,048 | $25.21 | $0.00 | $50.00 |
| 90837 | Psytx w pt 60 minutes | 450,720 | $80.75 | $0.00 | $393.82 |
| 99285 | Emergency dept visit hi mdm | 449,262 | $213.49 | $0.00 | $3,753.45 |
| 3074F | Syst bp lt 130 mm hg | 444,117 | $0.01 | $0.00 | $17.28 |
| D0150 | Comprehensve oral evaluation | 432,593 | $31.53 | $0.00 | $64.13 |
| 87086 | Urine culture/colony count | 418,449 | $5.76 | $0.00 | $259.89 |
| 84443 | Assay thyroid stim hormone | 415,052 | $8.34 | $0.00 | $276.30 |
| 3078F | Diast bp <80 mm hg | 409,301 | $0.00 | $0.00 | $0.01 |
| 81003 | Urinalysis auto w/o scope | 403,840 | $1.80 | $0.00 | $58.91 |
| D2930 | Prefab stnlss steel crwn pri | 398,590 | $138.89 | $0.00 | $183.08 |
| 99000 | Specimen handling office-lab | 398,204 | $7.75 | $0.00 | $33.85 |
| 90677 | Pcv20 vaccine im | 390,932 | $3.45 | $0.00 | $660.15 |
| D0602 | Caries risk assess mod risk | 390,180 | $0.03 | $0.00 | $6.82 |
| 99394 | Prev visit est age 12-17 | 390,001 | $85.33 | $0.00 | $392.53 |
| 90472 | Immunization admin each add | 389,466 | $6.97 | $0.00 | $40.36 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 386,447 | $38.45 | $0.00 | $132.63 |
| 99309 | Sbsq nf care moderate mdm 30 | 381,723 | $12.87 | $0.00 | $154.33 |
| 81001 | Urinalysis auto w/scope | 379,297 | $3.94 | $0.00 | $119.64 |
| 87651 | Strep a dna amp probe | 373,886 | $21.18 | $0.00 | $465.49 |
| 87400 | Influenza a/b each ag ia | 369,250 | $10.50 | $0.00 | $204.17 |
| T1002 | Rn services up to 15 minutes | 361,404 | $32.57 | $0.00 | $337.63 |
| H0020 | Alcohol and/or drug services | 359,289 | $13.15 | $0.00 | $184.54 |
| 1159F | Med list docd in rcrd | 359,077 | $0.00 | $0.00 | $0.00 |
| 87635 | Sars-cov-2 covid-19 amp prb | 349,186 | $31.79 | $0.00 | $542.75 |
| 99308 | Sbsq nf care low mdm 20 | 327,471 | $10.36 | $0.00 | $111.94 |
| 82306 | Vitamin d 25 hydroxy | 325,110 | $14.51 | $0.00 | $166.79 |
| 87811 | Sars-cov-2 covid19 w/optic | 323,145 | $32.94 | $0.00 | $64.55 |
| V2020 | Vision svcs frames purchases | 318,577 | $21.23 | $0.00 | $87.88 |
| 87389 | Hiv-1 ag w/hiv-1&-2 ab ag ia | 314,929 | $15.02 | $0.00 | $137.66 |
| 97112 | Neuromuscular reeducation | 314,311 | $19.62 | $0.00 | $465.29 |
| 87637 | Sarscov2&inf a&b&rsv amp prb | 310,242 | $125.79 | $0.00 | $530.50 |
| 80050 | General health panel | 300,380 | $26.85 | $0.00 | $1,037.74 |
| 1160F | Rvw meds by rx/dr in rcrd | 293,062 | $0.00 | $0.00 | $0.01 |
| 87661 | Trichomonas vaginalis amplif | 285,180 | $18.48 | $0.00 | $228.59 |
| T4535 | Disposable liner/shield/pad | 282,076 | $28.35 | $4.31 | $128.75 |
| T1027 | Family training & counseling | 279,445 | $110.82 | $0.00 | $129.13 |
| 96160 | Pt-focused hlth risk assmt | 279,168 | $1.09 | $0.00 | $27.05 |
| H2017 | Psysoc rehab svc, per 15 min | 279,116 | $140.70 | $0.00 | $415.81 |
| 99233 | Sbsq hosp ip/obs high 50 | 275,262 | $52.59 | $0.00 | $219.67 |