Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file

Who Medicaid paid,
line by line.

617,503 providers billed Medicaid $1.09T in outpatient and professional claims from January 2018 through December 2024. Every one of them is here, searchable by name or NPI.

28Total paid$1.09T
33Billing providers617,503
24DBilling codes used10,881
24ADates of service2018–2024
Box 24 · Service lines

The biggest line on Medicaid's bill isn't a doctor visit

  1. $123B
  2. $49B
  3. $35B
  4. $33B
  5. $31B
  6. $30B
  7. $20B
  8. $20B
  9. $17B
  10. $16B
  11. $15B
  12. $12B

The twelve largest billing codes by dollars paid, 2018–2024. See any state's codes or open a code for the providers who bill it.

T1019 is personal care: an aide helping someone bathe, get dressed, eat, and get around their own home, billed in fifteen-minute units. Medicaid paid $122.74B on it, nearly twice the $62.92B spent on the two most common doctor's office visits combined.

It is how Medicaid pays for long-term care at home instead of in a nursing home, and because it is billed by the quarter hour, the hours pile up. Much of it is billed by agencies and by fiscal intermediaries that pay family caregivers, which is why so many of the largest "providers" in this file are companies you've never heard of.

Read: where $122 billion in personal care went →

Box 33 · Billing provider

Who sent the bill

Of every dollar in this file, 33¢ went to agencies — home-care companies, case managers, community-support programs — and 11¢ to physicians.

  1. Agencies — home care, case management, community supportHome Health Agency · Community/Behavioral Health Agency · Case Management Agency
    33¢
  2. Clinics and outpatient centersFederally Qualified Health Center (FQHC) · Mental Health Clinic/Center (Including Community Mental Health Center) · Adult Day Care Clinic/Center
    16¢
  3. PhysiciansPediatrics Physician · Family Medicine Physician · Emergency Medicine Physician
    11¢
  4. Hospitals (outpatient claims only)General Acute Care Hospital · Critical Access Hospital · Children's Hospital
    7¢
  5. Counselors, therapists and social workersMental Health Counselor · Behavioral Analyst · Addiction (Substance Use Disorder) Counselor
    5¢
  6. Residential treatmentIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Substance Abuse Rehabilitation Facility · Intellectual and/or Developmental Disabilities Residential Treatment Facility
    4¢
  7. Medical equipment and suppliesDurable Medical Equipment & Medical Supplies · Customized Equipment (DME) · Parenteral & Enteral Nutrition Supplies (DME)
    4¢
  8. DentistsGeneral Practice Dentistry · Dentist · Pediatric Dentist
    4¢
  9. Rides and ambulancesLand Ambulance · Ambulance · Non-emergency Medical Transport (VAN)
    3¢
  10. LaboratoriesClinical Medical Laboratory · Physiological Laboratory · Dental Laboratory
    3¢
  11. Everything else
    11¢

Grouped by each billing NPI's primary provider type in NPPES (the NUCC taxonomy). The billing provider is whoever submitted the claim and got paid, which is not always who did the work.

Read this first

What this file can't see

Medicaid cost about $872 billion in 2023. This file accounts for $198.79B of it — roughly 23¢ on the dollar.

The HHS release covers outpatient and professional claims only, from fee-for-service, managed care and CHIP. It leaves out inpatient hospital stays, most nursing-home care, prescription drugs (published separately), and the part of managed-care payments that stays with the plans. So a hospital's page here shows its outpatient billing, not its total Medicaid revenue. 2023 total: CMS National Health Expenditure accounts.

Box 24A · By month

Seven years, month by month

$0$10B$20B2018201920202021202220232024
Paid that monthNov–Dec 2024: claims were still arriving when HHS cut the file

Monthly payments nearly doubled from 2018 to 2024. The drop at the very end is not a cut: providers have months to file, so the last weeks of 2024 were still coming in. Treat 2024 totals on any page here as incomplete.

Box 32 · Service location

By state

Less paidMore (fifths of states)

Totals follow population and how each state runs its program; a state whose spending flows mostly through inpatient or plan payments will look small here. By the billing provider's NPPES address.

All states as a list
StatePaid 2018–2024
New York$144.77B
California$129.43B
Texas$56.23B
Massachusetts$56.03B
New Jersey$46.95B
Michigan$38.86B
Ohio$36.98B
North Carolina$34.82B
Florida$34.03B
Arizona$33.08B
Virginia$29.49B
Missouri$28.01B
Pennsylvania$27.88B
Minnesota$25.25B
Kentucky$23.53B
Colorado$21.60B
Tennessee$20.40B
Illinois$19.86B
Louisiana$19.38B
Maryland$18.88B
Indiana$17.40B
Washington$16.65B
Connecticut$14.00B
New Mexico$13.69B
Iowa$11.67B
Alabama$10.35B
South Carolina$10.34B
Mississippi$10.06B
Wisconsin$9.81B
Oklahoma$9.49B
Maine$9.49B
West Virginia$8.56B
Arkansas$8.47B
Kansas$8.40B
Nevada$8.07B
Oregon$7.72B
Rhode Island$6.93B
Alaska$6.18B
District of Columbia$6.11B
New Hampshire$5.99B
Georgia$5.79B
Montana$5.37B
Utah$5.20B
Delaware$3.97B
Idaho$3.55B
Puerto Rico$3.23B
Hawaii$3.00B
Vermont$2.97B
South Dakota$2.51B
Nebraska$2.33B
North Dakota$2.16B
Wyoming$898.82M
Virgin Islands$185.84M
Guam$124.28M
Ranked

The largest billing providers

#ProviderTypeLocationClaimsPaid
1 PUBLIC PARTNERSHIPS LLC Agency Latham, NY 89,773,441 $7.18B
2 LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH Hospital Los Angeles, CA 30,870,976 $6.78B
3 TEMPUS UNLIMITED, INC. Agency Stoughton, MA 63,523,750 $5.57B
4 MODIVCARE SOLUTIONS, LLC Transport Denver, CO 107,716,418 $3.09B
5 FREEDOM CARE LLC Agency New Hyde Park, NY 21,977,069 $3.03B
6 GUARDIANTRAC. LLC Agency Sturgis, MI 35,557,539 $2.68B
7 DEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, STATE OF TN Agency Nashville, TN 16,349,155 $2.60B
8 ALABAMA DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION Agency Montgomery, AL 1,950,098 $2.25B
9 CONSUMER DIRECT CARE NETWORK VIRGINIA Missoula, MT 22,162,533 $2.11B
10 COUNTY OF SANTA CLARA Clinic San Jose, CA 4,656,205 $1.73B
11 AMERICAN BUSINESS INSTITUTE CORP Agency Flushing, NY 11,238,391 $1.68B
12 PREMIER HOME HEALTH CARE SERVICES INC Agency New York, NY 7,928,022 $1.48B
13 DEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, STATE OF TN Agency Nashville, TN 5,287,026 $1.45B
14 ASSISTCAREHOME HEALTHCARE SERVICES Agency Brooklyn, NY 9,386,423 $1.44B
15 LABORATORY CORPORATION OF AMERICA HOLDINGS Lab Burlington, NC 103,910,314 $1.44B
16 COUNTY OF RIVERSIDE Agency Riverside, CA 8,714,521 $1.40B
17 DEPARTMENT OF DEVELOPMENTAL SERVICES Agency Southbridge, MA 1,662,383 $1.35B
18 CITY & COUNTY OF SAN FRANCISCO Agency San Francisco, CA 6,184,815 $1.34B
19 COMPASS HEALTH, INC. Agency Clinton, MO 10,541,518 $1.28B
20 CITY OF CHICAGO Chicago, IL 1,593,649 $1.23B
21 COMMONWEALTH OF MASSACHUSETS Agency Beverly, MA 1,557,105 $1.14B
22 LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH Agency Alhambra, CA 14,999,665 $1.13B
23 NAE EDISON LLC Agency Brooklyn, NY 6,915,432 $1.11B
24 HEART TO HEART HOME CARE, INC. Agency Brooklyn, NY 7,622,845 $1.10B
25 COMMONWEALTH OF MASS-DDS Agency Hyde Park, MA 1,432,892 $1.10B
26 MARKS HOMECARE AGENCY INC Agency Corona, NY 6,692,707 $1.08B
27 YALE NEW HAVEN HOSPITAL Hospital New Haven, CT 23,557,851 $1.08B
28 NEW PARTNERS, INC Agency New York, NY 5,875,713 $1.08B
29 DEPARTMENT OF HEALTH AND SENIOR SERVICES Trenton, NJ 3,312,341 $1.07B
30 ALAMEDA COUNTY BEHAVIORAL HEALTH CARE Agency Oakland, CA 6,138,417 $1.07B
31 CONCEPTS OF INDEPENDENCE, INC. Agency New York, NY 5,015,054 $1.06B
32 ACUMEN FISCAL AGENT LLC Mesa, AZ 10,544,174 $1.06B
33 COUNTY OF SAN BERNARDINO Clinic San Bernardino, CA 6,532,613 $1.05B
34 COMMUNITY ASSISTANCE RESOURCES & EXTENDED SERVICES INC Agency New York, NY 2,757,160 $1.04B
35 STAVROS CENTER FOR INDEPENDENT LIVING, INC. Agency Amherst, MA 11,206,578 $1.04B
36 HEALTH ACQUISITION CORP. Agency Forest Hills, NY 5,716,218 $1.03B
37 MAINS'L FLORIDA, INC. Agency Brooklyn Park, MN 306,131 $996.80M
38 MONTEFIORE MEDICAL CENTER Hospital Bronx, NY 17,112,336 $961.14M
39 CARING PROFESSIONALS, INC Agency Forest Hills, NY 5,589,304 $953.48M
40 PURFOODS, LLC Ankeny, IA 51,017,667 $910.63M
Notes

Worth a look

All analysis →

Brooklyn's $31.8 Billion Personal Care Industry
318 providers in one borough bill almost exclusively one code — more than the entire Medicaid spending of most states.

The Fastest-Growing Medicaid Providers in America
Which providers saw the biggest spending increases from 2023 to 2024 — and what they're billing for.

The 25 Most Expensive Medicaid Billing Codes
From personal care to ambulance rides, here's where $1.09 trillion in Medicaid spending actually goes.

The $33.9 Billion Medicaid Transportation Machine
From ambulances to taxi companies, medical transportation is one of the largest and most fraud-prone categories in Medicaid.

Which States Spend the Most Per Medicaid Beneficiary?
Alaska spends $277 per beneficiary while Illinois spends $59 — a 4.7x gap that reflects very different Medicaid programs.

Every Medicaid Provider That Has Billed Over $1 Billion
40 providers have each billed more than $1 billion in Medicaid payments between 2018 and 2024. Here's the full list.

The Company That Billed $910 Million Delivering Meals
PurFoods LLC in Ankeny, Iowa is the largest single Medicaid meal delivery provider in the country.

Excluded Providers: $350 Million in Medicaid Payments to Banned Entities
Arizona and Ohio lead the nation in Medicaid spending on OIG-excluded providers — entities banned from federal healthcare programs.

Michigan's H2015 Anomaly: 235 Claims Per Beneficiary
A cluster of Michigan providers shows extreme claims-per-beneficiary ratios on community support billing code H2015.

Who Controls 2,000 Medicaid Providers? Entity Proliferation in the NPI Registry
A handful of authorized officials control thousands of Medicaid billing entities, representing billions in spending. Some are legitimate healthcare conglomerates. The pattern itself is worth understanding.

How One Program Drives Half of New York's Medicaid Spending
$74.6 billion in personal care billing — one code, one state, one program.

T1019: The $122 Billion Billing Code
Personal care services is the single largest Medicaid billing code — and the populations it serves are among the most vulnerable.

Rural Medicaid Spending: $138.8 Billion Across 102,819 Providers
County-level analysis of Medicaid spending in rural America using USDA RUCA codes — where the money goes, what it pays for, and how rural spending differs from urban.

Rural Substance Abuse Spending Tripled in Six Years
Medicaid spending on substance abuse treatment in rural America grew from $329 million in 2018 to over $1 billion in 2023 — a 208% increase across 1,566 providers in 41 states.

The Cost of Flying Rural Medicaid Patients: $1.8 Billion in Air Transport
Air ambulance billing codes are the most disproportionately rural category in all of Medicaid — with non-emergency air transport split nearly 50/50 between rural and urban despite rural areas accounting for just 12.8% of total spending.

Public Partnerships LLC — the largest biller: a fiscal intermediary that pays self-directed home caregivers.

ModivCare Solutions — Medicaid ride broker, filed in NPPES as a "taxi."

Brooklyn, NY — one borough billed $46.5B, more than every state but five.

How the billing flags work — and why a flag is not an accusation.