West Virginia Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in West Virginia, based on 2024 claims data.
2024 Overview
Procedures
1.7K
Total Claims
16.6M
Total Paid
$1.1B
Popular Services
Procedures
Showing 1–50 of 1,697 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 99213 | Office o/p est low 20 min | 1,270,729 | $33.12 | $0.00 | $222.86 |
| T1015 | Clinic service | 984,434 | $165.02 | $0.00 | $347.56 |
| 99214 | Office o/p est mod 30 min | 709,444 | $49.91 | $0.00 | $316.75 |
| H0004 | Alcohol and/or drug services | 486,954 | $83.86 | $0.00 | $191.23 |
| H2036 | A/d tx program, per diem | 314,704 | $212.08 | $67.54 | $652.07 |
| 87591 | N.gonorrhoeae dna amp prob | 294,634 | $26.02 | $0.00 | $53.70 |
| 87491 | Chlmyd trach dna amp probe | 294,360 | $26.44 | $0.00 | $53.70 |
| 85025 | Complete cbc w/auto diff wbc | 284,808 | $6.18 | $0.00 | $59.77 |
| 36415 | Coll venous bld venipuncture | 280,591 | $3.37 | $0.00 | $103.08 |
| 87661 | Trichomonas vaginalis amplif | 246,315 | $21.04 | $0.00 | $51.60 |
| 80053 | Comprehen metabolic panel | 235,637 | $9.85 | $0.00 | $221.10 |
| 99284 | Emergency dept visit mod mdm | 229,146 | $113.89 | $0.00 | $688.26 |
| 99212 | Office o/p est sf 10 min | 207,803 | $18.53 | $0.00 | $108.34 |
| S5125 | Attendant care service /15m | 203,803 | $756.39 | $72.32 | $6,070.77 |
| 99283 | Emergency dept visit low mdm | 185,312 | $82.03 | $0.00 | $948.16 |
| 97530 | Therapeutic activities | 181,130 | $95.28 | $0.32 | $430.01 |
| A0425 | Ground mileage | 159,931 | $88.37 | $1.13 | $742.60 |
| H0020 | Alcohol and/or drug services | 150,247 | $95.22 | $65.36 | $154.93 |
| 71045 | X-ray exam chest 1 view | 149,715 | $6.78 | $0.00 | $267.98 |
| G9002 | Mccd,maintenance rate | 140,314 | $187.22 | $33.89 | $233.04 |
| 87798 | Detect agent nos dna amp | 140,187 | $38.70 | $0.00 | $151.60 |
| 90837 | Psytx w pt 60 minutes | 134,285 | $85.55 | $0.00 | $140.98 |
| 88175 | Cytopath c/v auto fluid redo | 132,652 | $16.41 | $0.00 | $39.49 |
| H0040 | Assert comm tx pgm per diem | 130,839 | $78.16 | $60.75 | $110.44 |
| T2021 | Day habil waiver per 15 min | 122,316 | $148.04 | $16.53 | $1,044.69 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 121,160 | $44.86 | $0.00 | $157.08 |
| 80307 | Drug test prsmv chem anlyzr | 118,611 | $42.78 | $0.00 | $179.17 |
| 87801 | Detect agnt mult dna ampli | 117,728 | $47.54 | $4.40 | $59.67 |
| H0038 | Self-help/peer svc per 15min | 111,369 | $85.37 | $0.00 | $161.66 |
| 93010 | Electrocardiogram report | 105,647 | $4.62 | $0.00 | $11.05 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or | 105,513 | $58.01 | $11.04 | $150.19 |
| 97110 | Therapeutic exercises | 101,926 | $27.75 | $0.00 | $147.95 |
| 99285 | Emergency dept visit hi mdm | 98,415 | $195.63 | $7.85 | $950.73 |
| H0019 | Alcohol and/or drug services | 98,298 | $212.83 | $0.00 | $5,351.58 |
| T1002 | Rn services up to 15 minutes | 97,483 | $45.27 | $5.72 | $569.80 |
| 87624 | Hpv hi-risk typ pooled rslt | 93,334 | $22.63 | $0.92 | $36.06 |
| 87880 | Strep a assay w/optic | 85,302 | $7.80 | $0.00 | $39.78 |
| 80305 | Drug test prsmv dir opt obs | 83,784 | $8.60 | $0.00 | $55.63 |
| 93005 | Electrocardiogram tracing | 83,482 | $6.20 | $0.00 | $167.18 |
| G0480 | Drug test def 1-7 classes | 82,651 | $66.01 | $0.00 | $216.28 |
| 71046 | X-ray exam chest 2 views | 79,051 | $9.71 | $0.00 | $312.81 |
| 99204 | Office o/p new mod 45 min | 73,889 | $84.97 | $0.00 | $153.14 |
| D0120 | Periodic oral evaluation | 73,319 | $24.24 | $0.00 | $36.54 |
| 81001 | Urinalysis auto w/scope | 72,312 | $3.44 | $0.09 | $47.72 |
| A0160 | Noner transport case worker | 69,945 | $44.19 | $0.00 | $424.26 |
| 87804 | Influenza assay w/optic | 69,939 | $10.86 | $0.00 | $83.07 |
| 90471 | Immunization admin | 69,175 | $7.54 | $-18.08 | $24.59 |
| 99203 | Office o/p new low 30 min | 69,010 | $57.79 | $0.00 | $86.93 |
| 99211 | Off/op est may x req phy/qhp | 68,813 | $15.91 | $0.00 | $92.06 |
| 90832 | Psytx w pt 30 minutes | 68,166 | $22.93 | $0.00 | $89.62 |