| T1016 | Case management, each 15 minutes | 19,000 | $30 | $626.9K |
| S9480 | Intensive outpatient psychiatric services, per diem | 4,820 | $100 | $501.7K |
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including… | 4,240 | $70 | $284K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 3,840 | $50 | $196K |
| 90833 | In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the… | 3,520 | $30 | $102K |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 930 | $110 | $98.8K |
| Q3014 | Telehealth originating site facility fee | 3,170 | $20 | $57K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 750 | $70 | $55.6K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 400 | $120 | $45.9K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 720 | $60 | $43.9K |