Utah Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Utah, based on 2024 claims data.
2024 Overview
Procedures
1.6K
Total Claims
10.4M
Total Paid
$707.7M
Popular Services
Procedures
Showing 51–100 of 1,571 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99233 | Sbsq hosp ip/obs high 50 | 41,470 | $70.58 | $24.05 | $103.16 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or | 40,227 | $76.93 | $0.35 | $214.29 |
| 99391 | Per pm reeval est pat infant | 38,432 | $45.31 | $3.02 | $719.00 |
| G0481 | Drug test def 8-14 classes | 38,066 | $69.18 | $0.00 | $126.77 |
| H0006 | Alcohol and/or drug services | 37,785 | $43.29 | $4.84 | $656.48 |
| 99204 | Office o/p new mod 45 min | 37,034 | $98.54 | $0.00 | $719.00 |
| 97112 | Neuromuscular reeducation | 36,771 | $32.41 | $0.00 | $359.50 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 34,721 | $44.54 | $7.51 | $59.34 |
| 99203 | Office o/p new low 30 min | 33,651 | $76.55 | $0.00 | $719.00 |
| A0429 | Bls-emergency | 32,541 | $947.10 | $602.25 | $1,176.11 |
| T1001 | Nursing assessment/evaluatn | 31,973 | $97.81 | $27.53 | $1,046.58 |
| 99283 | Emergency dept visit low mdm | 31,492 | $98.73 | $13.32 | $372.80 |
| 3074F | Syst bp lt 130 mm hg | 28,138 | $0.00 | $0.00 | $0.01 |
| D0274 | Bitewings four images | 27,784 | $39.04 | $0.00 | $133.70 |
| 90791 | Psych diagnostic evaluation | 27,490 | $227.12 | $0.00 | $886.22 |
| 90832 | Psytx w pt 30 minutes | 27,312 | $85.77 | $0.00 | $719.00 |
| 99392 | Prev visit est age 1-4 | 26,649 | $40.11 | $0.00 | $719.00 |
| H0038 | Self-help/peer svc per 15min | 26,560 | $46.28 | $0.59 | $369.33 |
| 96127 | Brief emotional/behav assmt | 25,676 | $1.81 | $0.00 | $10.60 |
| T1000 | Private duty/independent nsg | 25,672 | $426.19 | $195.80 | $511.88 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, | 24,231 | $14.62 | $0.00 | $39.59 |
| H2013 | Psych hlth fac svc, per diem | 23,583 | $565.29 | $255.28 | $9,512.18 |
| D2392 | Post 2 srfc resinbased cmpst | 22,252 | $99.19 | $5.80 | $639.11 |
| 83036 | Hemoglobin glycosylated a1c | 22,023 | $11.32 | $0.00 | $224.69 |
| 3078F | Diast bp <80 mm hg | 21,942 | $0.00 | $0.00 | $0.01 |
| 99310 | Sbsq nf care high mdm 45 | 21,620 | $44.76 | $3.55 | $116.91 |
| H2036 | A/d tx program, per diem | 21,188 | $430.57 | $188.09 | $2,530.70 |
| 74177 | Ct abd & pelvis w/contrast | 20,788 | $53.78 | $36.73 | $1,108.49 |
| 96372 | Ther/proph/diag inj sc/im | 20,335 | $23.82 | $0.00 | $479.33 |
| S5150 | Unskilled respite care /15m | 19,633 | $104.25 | $0.00 | $232.89 |
| 71046 | X-ray exam chest 2 views | 19,414 | $8.76 | $1.23 | $94.65 |
| A0382 | Basic support routine suppls | 18,932 | $0.07 | $0.00 | $2.57 |
| A4927 | Non-sterile gloves | 18,702 | $10.58 | $1.91 | $17.32 |
| 99223 | 1st hosp ip/obs high 75 | 18,588 | $94.86 | $17.26 | $143.60 |
| D0140 | Limit oral eval problm focus | 18,373 | $190.41 | $0.00 | $623.05 |
| 99393 | Prev visit est age 5-11 | 18,161 | $54.29 | $0.00 | $719.00 |
| 96110 | Developmental screen w/score | 18,107 | $4.32 | $0.00 | $8.72 |
| 92015 | Determine refractive state | 18,038 | $2.31 | $0.00 | $24.93 |
| 97014 | Electric stimulation therapy | 18,000 | $7.89 | $0.00 | $41.80 |
| S9122 | Home health aide or certifie | 17,870 | $106.64 | $25.56 | $187.21 |
| 1159F | Med list docd in rcrd | 17,523 | $0.00 | $0.00 | $0.01 |
| 80305 | Drug test prsmv dir opt obs | 17,504 | $6.51 | $0.00 | $62.52 |
| 90847 | Family psytx w/pt 50 min | 17,029 | $140.84 | $6.07 | $282.95 |
| 99211 | Off/op est may x req phy/qhp | 16,706 | $65.84 | $5.21 | $719.00 |
| T1002 | Rn services up to 15 minutes | 16,609 | $120.47 | $0.00 | $806.72 |
| H2027 | Psychoed svc, per 15 min | 15,754 | $144.86 | $21.66 | $337.15 |
| 87880 | Strep a assay w/optic | 15,726 | $11.80 | $0.00 | $47.93 |
| 99291 | Critical care first hour | 15,474 | $166.44 | $101.86 | $233.27 |
| 88305 | Tissue exam by pathologist | 15,021 | $57.84 | $0.00 | $140.68 |
| 90833 | Psytx w pt w e/m 30 min | 14,782 | $48.45 | $0.00 | $71.29 |