Vermont Medicaid Reimbursement Rates

What Medicaid pays for medical procedures and services in Vermont, based on 2024 claims data.

2024 Overview

Procedures
705
Total Claims
3.5M
Total Paid
$467.9M

Popular Services

Procedures

Showing 1–50 of 705 procedures, sorted by most claims.

HCPCS CodeDescriptionTotal ClaimsAvg PaymentMin PaymentMax Payment
H2015Comp comm supp svc, 15 min217,807$129.61$0.00$811.62
S5140Adult foster care per diem217,290$0.00$0.00$0.00
T1016Case management206,602$0.70$0.00$271.74
T1015Clinic service206,564$176.11$0.00$320.98
T2021Day habil waiver per 15 min191,037$19.20$0.00$286.04
90837Psytx w pt 60 minutes187,140$74.64$0.00$174.39
99213Office o/p est low 20 min175,914$16.95$0.00$176.49
99214Office o/p est mod 30 min175,836$34.12$0.00$198.13
S5150Unskilled respite care /15m104,214$0.00$0.00$0.00
H2017Psysoc rehab svc, per 15 min89,265$23.60$0.00$242.92
G2067Med assist tx meth wk76,082$190.27$0.18$190.82
T2016Habil res waiver per diem62,338$0.00$0.00$0.00
D1206Topical fluoride varnish51,625$29.83$0.00$33.75
H2025Supp maint employ, 15 min50,298$0.00$0.00$0.00
D0120Periodic oral evaluation47,026$35.25$0.00$41.54
3074FSyst bp lt 130 mm hg39,425$0.02$0.00$2.96
90834Psytx w pt 45 minutes36,649$15.95$0.00$134.72
3078FDiast bp <80 mm hg36,167$0.02$0.00$2.78
S5151Unskilled respitecare /diem32,929$0.00$0.00$0.00
99199Unlisted special svc px/rprt30,910$7,522.54$0.00$13,584.93
D1110Dental prophylaxis adult30,159$65.86$0.00$80.48
93010Electrocardiogram report29,073$1.59$0.00$6.27
A0425Ground mileage28,361$64.73$3.00$393.79
T2033Res, nos waiver per diem27,459$202.07$0.00$973.27
T2017Habil res waiver 15 min26,560$0.00$0.00$0.00
T1020Personal care ser per diem25,804$434.02$375.78$1,894.71
D1120Dental prophylaxis child25,285$54.18$0.00$60.75
H0020Alcohol and/or drug services23,880$443.67$104.73$632.72
99284Emergency dept visit mod mdm23,304$22.45$0.00$293.02
99283Emergency dept visit low mdm20,647$17.71$0.00$172.05
H2020Ther behav svc, per diem19,710$424.78$154.11$520.79
G0467Fqhc visit, estab pt19,545$29.82$0.00$39.89
92015Determine refractive state18,483$13.97$0.00$30.73
98941Chiropract manj 3-4 regions18,336$25.85$0.00$37.16
D0274Bitewings four images15,754$42.91$0.00$52.64
D1351Dental sealant per tooth15,386$23.37$0.00$43.50
99215Office o/p est hi 40 min15,264$70.57$0.00$194.64
H2014Skills train and dev, 15 min14,722$8.53$0.00$124.78
90832Psytx w pt 30 minutes14,674$26.52$0.00$69.31
90471Immunization admin14,588$4.02$0.00$22.65
T1024Team evaluation & management14,252$596.41$8.23$650.00
T1017Targeted case management13,314$23.82$0.00$86.00
H2011Crisis interven svc, 15 min13,177$0.13$0.00$8.02
90460Im admin 1st/only component13,033$6.48$0.00$57.52
D0220Intraoral periapical first12,962$20.31$0.00$25.91
99232Sbsq hosp ip/obs moderate 3512,886$31.82$0.00$75.19
D0140Limit oral eval problm focus12,040$53.68$0.00$63.75
H0023Alcohol and/or drug outreach11,661$1,143.27$471.79$2,462.83
A0429Bls-emergency11,473$244.12$120.81$443.00
H2023Supported employ, per 15 min10,947$0.00$0.00$0.00