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 101–150 of 3,181 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 85027 | Complete cbc automated | 270,996 | $4.93 | $0.00 | $127.20 |
| 71046 | X-ray exam chest 2 views | 267,322 | $15.70 | $0.00 | $412.98 |
| 99203 | Office o/p new low 30 min | 266,979 | $76.77 | $0.00 | $454.55 |
| 99173 | Visual acuity screen | 263,896 | $0.15 | $0.00 | $36.64 |
| 90834 | Psytx w pt 45 minutes | 262,027 | $46.04 | $0.00 | $277.95 |
| 76816 | Ob us follow-up per fetus | 254,321 | $76.25 | $0.00 | $367.59 |
| 84439 | Assay of free thyroxine | 250,629 | $5.87 | $0.00 | $151.51 |
| 93010 | Electrocardiogram report | 233,598 | $5.51 | $0.00 | $23.77 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | 223,570 | $0.92 | $0.00 | $63.21 |
| 2001F | Weight record | 223,053 | $0.00 | $0.00 | $0.00 |
| 90686 | Iiv4 vacc no prsv 0.5 ml im | 222,298 | $0.53 | $0.00 | $40.27 |
| 87481 | Candida dna amp probe | 217,454 | $22.05 | $0.00 | $91.38 |
| 83655 | Assay of lead | 212,179 | $9.07 | $0.00 | $65.51 |
| A6250 | Skin seal protect moisturizr | 211,855 | $4.84 | $0.00 | $198.62 |
| 90633 | Hepa vacc ped/adol 2 dose im | 210,742 | $0.24 | $0.00 | $45.38 |
| 86592 | Syphilis test non-trep qual | 209,347 | $2.45 | $0.00 | $70.36 |
| 92551 | Pure tone hearing test air | 208,952 | $1.78 | $0.00 | $53.81 |
| T1502 | Medication admin visit | 206,523 | $5.09 | $0.00 | $10.49 |
| B4161 | Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain | 204,581 | $335.06 | $196.92 | $1,870.60 |
| T4527 | Adult size pull-on lg | 203,967 | $97.17 | $19.11 | $188.81 |
| 87631 | Resp virus 3-5 targets | 200,575 | $50.59 | $0.00 | $348.00 |
| 1036F | Tobacco non-user | 199,796 | $0.00 | $0.00 | $0.48 |
| 74018 | Radex abdomen 1 view | 193,287 | $9.20 | $0.00 | $356.10 |
| 90680 | Rv5 vacc 3 dose live oral | 193,216 | $0.10 | $0.00 | $25.31 |
| 70450 | Ct head/brain w/o dye | 192,316 | $31.07 | $0.00 | $1,290.55 |
| 87653 | Strep b dna amp probe | 190,399 | $13.51 | $0.00 | $68.59 |
| 87428 | Sarscov & inf vir a&b ag ia | 190,363 | $30.03 | $0.00 | $597.13 |
| 86803 | Hepatitis c ab test | 185,062 | $7.65 | $0.00 | $85.29 |
| 87081 | Culture screen only | 184,760 | $4.53 | $0.00 | $94.98 |
| 81025 | Urine pregnancy test | 184,661 | $5.73 | $0.00 | $111.21 |
| 92015 | Determine refractive state | 184,181 | $11.39 | $0.00 | $45.00 |
| 96372 | Ther/proph/diag inj sc/im | 182,884 | $9.75 | $0.00 | $131.72 |
| 80048 | Basic metabolic pnl total ca | 181,109 | $12.21 | $0.00 | $453.91 |
| D0330 | Panoramic image | 181,102 | $28.09 | $0.00 | $88.52 |
| 90832 | Psytx w pt 30 minutes | 179,667 | $33.33 | $0.00 | $244.29 |
| D0601 | Caries risk assess low risk | 178,707 | $0.02 | $0.00 | $10.00 |
| 87581 | M.pneumon dna amp probe | 178,623 | $13.62 | $0.00 | $112.96 |
| 99211 | Off/op est may x req phy/qhp | 178,313 | $37.32 | $0.00 | $195.54 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 177,354 | $19.35 | $0.00 | $123.85 |
| T4526 | Adult size pull-on med | 176,108 | $80.16 | $0.00 | $150.22 |
| B4160 | Enteral formula, for pediatrics, nutritionally complete calorically dense | 174,726 | $173.33 | $52.86 | $534.39 |
| 87640 | Staph a dna amp probe | 174,025 | $11.20 | $0.00 | $30.34 |
| A0427 | Als1-emergency | 172,257 | $212.89 | $0.00 | $1,622.29 |
| 76819 | Fetal biophys profil w/o nst | 171,071 | $57.85 | $0.00 | $302.43 |
| 87486 | Chlmyd pneum dna amp probe | 168,295 | $13.10 | $0.00 | $112.96 |
| 99215 | Office o/p est hi 40 min | 167,624 | $80.03 | $0.00 | $481.12 |
| 85018 | Hemoglobin | 166,311 | $1.69 | $0.00 | $28.57 |
| 88175 | Cytopath c/v auto fluid redo | 164,842 | $15.77 | $0.00 | $70.80 |
| 99204 | Office o/p new mod 45 min | 164,617 | $85.66 | $0.00 | $258.37 |
| T2040 | Financial mgt waiver/15min | 163,441 | $158.24 | $50.38 | $360.76 |