Wisconsin Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Wisconsin, based on 2024 claims data.
2024 Overview
Procedures
2.4K
Total Claims
36.4M
Total Paid
$1.8B
Popular Services
Procedures
Showing 1–50 of 2,378 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| H2017 | Psysoc rehab svc, per 15 min | 1,466,584 | $115.02 | $0.00 | $259.25 |
| S5125 | Attendant care service /15m | 1,287,051 | $14.84 | $0.00 | $944.51 |
| T1017 | Targeted case management | 1,137,328 | $124.16 | $0.00 | $802.82 |
| 99213 | Office o/p est low 20 min | 1,054,298 | $55.58 | $0.00 | $347.87 |
| H0020 | Alcohol and/or drug services | 1,049,907 | $9.86 | $0.00 | $73.83 |
| T1016 | Case management | 1,008,209 | $78.13 | $0.00 | $771.89 |
| 99214 | Office o/p est mod 30 min | 971,736 | $59.25 | $0.00 | $426.96 |
| 85025 | Complete cbc w/auto diff wbc | 654,840 | $5.35 | $0.00 | $25.24 |
| 80053 | Comprehen metabolic panel | 553,103 | $11.87 | $0.00 | $89.81 |
| 92507 | Tx sp lang voice comm indiv | 526,470 | $20.86 | $0.00 | $107.40 |
| H0039 | Asser com tx face-face/15min | 518,839 | $32.12 | $0.00 | $3,420.45 |
| 97110 | Therapeutic exercises | 513,361 | $20.78 | $0.00 | $118.93 |
| 36415 | Coll venous bld venipuncture | 498,111 | $0.32 | $0.00 | $19.82 |
| 99199 | Unlisted special svc px/rprt | 456,098 | $66.41 | $0.00 | $187.54 |
| 99284 | Emergency dept visit mod mdm | 441,608 | $78.00 | $0.00 | $661.84 |
| T2003 | N-et; encounter/trip | 429,824 | $26.95 | $0.73 | $589.33 |
| 98941 | Chiropract manj 3-4 regions | 429,703 | $22.05 | $0.00 | $38.47 |
| 92508 | Tx sp lang voice comm group | 429,420 | $5.41 | $0.00 | $21.07 |
| 97153 | Adaptive behavior tx by tech | 397,031 | $84.19 | $0.00 | $407.09 |
| 99283 | Emergency dept visit low mdm | 388,250 | $90.55 | $3.81 | $562.09 |
| 90999 | Unlisted dialysis procedure | 324,750 | $55.08 | $0.43 | $225.29 |
| 90837 | Psytx w pt 60 minutes | 316,447 | $73.56 | $0.00 | $160.99 |
| D1206 | Topical fluoride varnish | 298,769 | $15.36 | $0.00 | $46.93 |
| 81528 | Oncology colorectal scr | 291,936 | $317.98 | $184.26 | $483.89 |
| 90834 | Psytx w pt 45 minutes | 269,417 | $42.86 | $0.00 | $236.55 |
| 99285 | Emergency dept visit hi mdm | 244,080 | $78.67 | $0.00 | $439.32 |
| D1351 | Dental sealant per tooth | 238,811 | $22.82 | $0.00 | $144.57 |
| 80048 | Basic metabolic pnl total ca | 235,227 | $10.51 | $0.00 | $88.03 |
| 71045 | X-ray exam chest 1 view | 223,289 | $3.01 | $0.00 | $30.97 |
| 81001 | Urinalysis auto w/scope | 217,729 | $3.20 | $0.00 | $25.44 |
| A9150 | Misc/exper non-prescript dru | 207,105 | $30.70 | $0.00 | $1,090.98 |
| 93005 | Electrocardiogram tracing | 206,722 | $1.17 | $0.00 | $23.96 |
| 80061 | Lipid panel | 202,033 | $10.28 | $0.00 | $110.63 |
| D0120 | Periodic oral evaluation | 194,563 | $21.63 | $0.00 | $265.07 |
| 83036 | Hemoglobin glycosylated a1c | 192,515 | $7.63 | $0.00 | $43.99 |
| 84443 | Assay thyroid stim hormone | 189,234 | $12.80 | $0.00 | $65.36 |
| T1005 | Respite care service 15 min | 188,347 | $90.93 | $65.04 | $3,394.50 |
| T1015 | Clinic service | 186,220 | $299.76 | $0.00 | $719.00 |
| A4657 | Syringe w/wo needle | 180,802 | $0.04 | $0.00 | $14.50 |
| 93010 | Electrocardiogram report | 177,313 | $6.08 | $0.00 | $12.42 |
| D1120 | Dental prophylaxis child | 175,721 | $30.48 | $0.00 | $79.77 |
| 97530 | Therapeutic activities | 161,138 | $39.71 | $0.00 | $136.26 |
| 83735 | Assay of magnesium | 160,377 | $4.10 | $0.00 | $55.35 |
| 96374 | Ther/proph/diag inj iv push | 158,294 | $2.29 | $0.00 | $53.29 |
| S5130 | Homaker service nos per 15m | 156,247 | $126.39 | $24.92 | $1,984.34 |
| 85027 | Complete cbc automated | 148,186 | $4.67 | $0.00 | $33.32 |
| T1019 | Personal care ser per 15 min | 145,012 | $65.08 | $0.00 | $146.74 |
| H2012 | Behav hlth day treat, per hr | 140,345 | $116.93 | $1.30 | $193.53 |
| 87086 | Urine culture/colony count | 138,244 | $8.13 | $0.00 | $44.45 |
| 84484 | Assay of troponin quant | 138,161 | $7.75 | $0.00 | $29.11 |