40 providers have each billed more than $1 billion in Medicaid payments between 2018 and 2024. Here's the full list.
Out of 617,503 providers in the HHS Medicaid spending dataset, exactly 40 have billed over $1 billion between January 2018 and December 2024. Together, they account for roughly $70 billion — about 6.4% of the $1.09 trillion total.
The list is a mix of state agencies, county health departments, home care agencies, hospitals, fiscal intermediaries, and a few names that raise questions.
The Complete List
| # | Provider | Location | Total Paid | Codes | Type |
|---|
| 1 | Public Partnerships LLC | Latham, NY | $7.18B | 25 | Fiscal Intermediary |
| 2 | LA County Dept. of Mental Health | Los Angeles, CA | $6.78B | 117 | County Mental Health |
| 3 | Tempus Unlimited, Inc. | Stoughton, MA | $5.57B | 5 | Fiscal Intermediary |
| 4 | ModivCare Solutions, LLC | Denver, CO | $3.09B | 44 | Transportation (Taxi) |
| 5 | Freedom Care LLC | New Hyde Park, NY | $3.03B | 6 | Home Health |
| 6 | GuardianTrac. LLC | Sturgis, MI | $2.68B | 68 | Supports Brokerage |
| 7 | TN Dept. of Intellectual and Developmental Disabilities | Nashville, TN | $2.60B | 72 | State Agency |
| 8 | Alabama Dept. of Mental Health | Montgomery, AL | $2.25B | 21 | State Agency |
| 9 | Consumer Direct Care Network Virginia | Missoula, MT | $2.11B | 5 | Fiscal Intermediary |
| 10 | County of Santa Clara | San Jose, CA | $1.73B | 59 | County Health |
| 11 | American Business Institute Corp | Flushing, NY | $1.68B | 5 | Home Health |
| 12 | Premier Home Health Care Services Inc | New York, NY | $1.48B | 11 | Home Health |
| 13 | TN Dept. of Intellectual and Developmental Disabilities | Nashville, TN | $1.45B | 53 | State Agency (2nd NPI) |
| 14 | AssistCareHome Healthcare Services | Brooklyn, NY | $1.44B | 17 | Home Health |
| 15 | Laboratory Corporation of America | Burlington, NC | $1.44B | 747 | Clinical Lab |
| 16 | County of Riverside | Riverside, CA | $1.40B | 82 | County Health |
| 17 | MA Dept. of Developmental Services | Southbridge, MA | $1.35B | 16 | State Agency |
| 18 | City & County of San Francisco | San Francisco, CA | $1.34B | 61 | County Health |
| 19 | Compass Health, Inc. | Clinton, MO | $1.28B | 39 | Community Behavioral Health |
| 20 | City of Chicago | Chicago, IL | $1.23B | 5 | Emergency Medical Technician |
| 21 | Commonwealth of Massachusetts | Beverly, MA | $1.14B | 13 | Case Management Agency |
| 22 | LA County Dept. of Public Health | Alhambra, CA | $1.13B | 37 | Public Health |
| 23 | NAE Edison LLC | Brooklyn, NY | $1.11B | 10 | Home Health |
| 24 | Heart to Heart Home Care, Inc. | Brooklyn, NY | $1.10B | 9 | Home Health |
| 25 | Commonwealth of Mass-DDS | Hyde Park, MA | $1.10B | 10 | State Agency |
| 26 | Marks Homecare Agency Inc | Corona, NY | $1.08B | 4 | Home Health |
| 27 | Yale New Haven Hospital | New Haven, CT | $1.08B | 1,431 | Hospital |
| 28 | New Partners, Inc | New York, NY | $1.08B | 7 | Home Health |
| 29 | NJ Dept. of Health and Senior Services | Trenton, NJ | $1.07B | 3 | State Agency |
| 30 | Alameda County Behavioral Health Care | Oakland, CA | $1.07B | 65 | County Behavioral Health |
| 31 | Concepts of Independence, Inc. | New York, NY | $1.06B | 6 | Home Health |
| 32 | Acumen Fiscal Agent LLC | Mesa, AZ | $1.06B | 47 | Fiscal Intermediary |
| 33 | County of San Bernardino | San Bernardino, CA | $1.05B | 58 | County Health |
| 34 | CARES Inc | New York, NY | $1.04B | 17 | Community Health |
| 35 | Stavros Center for Independent Living | Amherst, MA | $1.04B | 2 | Case Management |
| 36 | Health Acquisition Corp. | Forest Hills, NY | $1.03B | 9 | Home Health |
| 37 | Mains'l Florida, Inc. | Brooklyn Park, MN | $1.00B | 2 | Home Health |
What Patterns Emerge
Government agencies make up a large share. State departments, county health systems, and city agencies account for roughly a third of the billion-dollar billers. These are entities like the LA County Department of Mental Health or Tennessee DIDD — large public systems providing services to hundreds of thousands of people.
Fiscal intermediaries are huge. Public Partnerships LLC is the #1 biller at $7.18 billion, but it's not providing care — it's a fiscal intermediary that processes payments for self-directed care programs. Tempus Unlimited ($5.57B) and Consumer Direct ($2.11B) serve similar roles. These are the billing infrastructure of Medicaid, not the care delivery.
Brooklyn home health agencies cluster together. Seven of the 40 billion-dollar providers are home health agencies in the New York metro area, most billing overwhelmingly on code T1019 with only 4-10 total billing codes. This pattern is explored in depth in our Brooklyn personal care analysis.
Code count tells a story. Yale New Haven Hospital bills 1,431 different codes — that's a full-service hospital. Marks Homecare Agency bills 4. Stavros Center bills 2. Mains'l Florida bills 2. The narrower the billing profile at these spending levels, the more concentrated the operation.
Names that raise questions. American Business Institute Corp — a "home health" provider in Flushing, NY that has billed $1.68 billion, 96.6% on personal care services. Mains'l Florida, Inc. — based in Brooklyn Park, Minnesota, billing $1 billion for Florida supported housing services, 100% on a single code. City of Chicago — classified as an "Emergency Medical Technician" entity, billing $1.23 billion across just 5 codes.
Explore Individual Providers
Click any provider name to see their complete billing history, monthly trends, yearly breakdown, and every code they bill. Or browse the top 50 nationally from the homepage.