Addiction Medicine
What they do most for Medicare patients
| Service, sort | Times billed, sort |
|---|---|
| Established patient office or other outpatient visit, 30-39 minutes | 48,510 |
| Established patient office or other outpatient visit, 20-29 minutes | 23,938 |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 18,332 |
| Testing for presence of drug, by chemistry analyzers | 13,695 |
| Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 12,690 |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 7,306 |
| Psychotherapy with evaluation and management visit, 30 minutes | 5,542 |
| Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow | 4,933 |
| Testing for presence of drug, read by direct observation | 4,918 |
| Established patient office or other outpatient visit, 40-54 minutes | 4,655 |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 4,100 |
| Insertion of needle into vein for collection of blood sample | 3,861 |
| Take-home supply of buprenorphine (oral); up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | 3,558 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 3,482 |
| Medication assisted treatment, buprenorphine (oral); weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opi | 3,237 |
| Periodic assessment; assessing periodically by qualified personnel to determine the most appropriate combination of services and treatment (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for | 3,146 |
| Injection of drug or substance under skin or into muscle | 3,106 |
| Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 2,926 |
| Telehealth originating site facility fee | 2,666 |
| Emergency department visit with high level of medical decision making | 2,525 |
| Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 2,495 |
| Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 2,487 |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 2,078 |
| Hospital discharge day management, more than 30 minutes | 1,969 |
| Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 1,959 |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 1,921 |
| Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month | 1,850 |
| Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 1,841 |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1,752 |
| Established patient office or other outpatient visit, 10-19 minutes | 1,665 |
| New patient office or other outpatient visit, 45-59 minutes | 1,653 |
| Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 1,516 |
| Emergency department visit with moderate level of medical decision making | 1,510 |
| Hospital discharge day management, 30 minutes or less | 1,490 |
| Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 1,263 |
| Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a | 1,152 |
| Hemoglobin a1c level | 1,134 |
| Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 1,120 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 1,085 |
| Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 1,059 |
| Blood test, comprehensive group of blood chemicals | 1,016 |
| Assessment of emotional or behavioral problems | 994 |
| Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 975 |
| Blood test, clotting time | 931 |
| New patient office or other outpatient visit, 30-44 minutes | 927 |
| Blood test, lipids (cholesterol and triglycerides) | 923 |
| Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm | 912 |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 904 |
| Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 799 |
| Smoking and tobacco use intensive counseling, 4-10 minutes | 789 |
| Telephone medical discussion with physician, 11-20 minutes | 763 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 745 |
| Aspiration and/or injection of fluid from large joint | 735 |
| Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional | 691 |
| New patient office or other outpatient visit, 60-74 minutes | 689 |
| Annual depression screening, 5 to 15 minutes | 687 |
| Psychiatric diagnostic evaluation with medical services | 674 |
| Administration of influenza virus vaccine | 649 |
| Fluoroscopic guidance for needle placement | 633 |
| Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 595 |
| Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 586 |
| Blood test, basic group of blood chemicals (calcium, total) | 558 |
| Automated urinalysis test | 553 |
| Critical care, first 30-74 minutes | 552 |
| X-ray of chest, 2 views | 524 |
| Infusion into a vein for therapy, prevention, or diagnosis, each additional hour | 523 |
| Telephone medical discussion with physician, 21-30 minutes | 519 |
| Psychotherapy, 1 hour | 515 |
| Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management | 465 |
| Telephone medical discussion with physician, 5-10 minutes | 444 |
| Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or | 380 |
| Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid treatment program) | 375 |
| X-ray of chest, 1 view | 371 |
| Injection of substance into lower spine canal using imaging guidance | 365 |
| Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less | 360 |
| Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes | 359 |
| Annual alcohol misuse screening, 5 to 15 minutes | 341 |
| Detection test by immunoassay with direct visual observation for influenza virus | 337 |
| Urinalysis, manual test | 335 |
| Needle measurement of electrical activity in arm or leg muscles, complete study | 333 |
| Emergency department visit with low level of medical decision making | 333 |
| Blood test, thyroid stimulating hormone (tsh) | 333 |
| Group psychotherapy | 319 |
| Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance | 304 |
| Extended office or other outpatient service by clinical staff, first hour | 290 |
| Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 288 |
| Psychotherapy with evaluation and management visit, 45 minutes | 281 |
| Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan tha | 276 |
| Removal of skin and tissue, 20.0 sq cm or less | 273 |
| Injection of trigger points, 3 or more muscles | 267 |
| Injection of drug or substance into vein | 266 |
| Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | 263 |
| Injection of lower or sacral spine facet joint using imaging guidance, single level | 258 |
| Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint | 236 |
| Evaluation of neuropsychological test, first hour | 229 |
| Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | 226 |
| Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 226 |
| Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 224 |
| Blood glucose (sugar) test performed by hand-held instrument | 220 |
| Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | 220 |
Sources: Medicare Care Compare (hospitals and schools; Medicare-enrolled clinicians), CMS Medicare Physician & Other Practitioners 2023 (services), Medicare Part D Prescribers 2024 (drugs).