Alabama's 6,550 Medicaid providers billed $10.35B between 2018 and 2024. The most-billed code is T2016, accounting for $1.83B in payments. Montgomery is the largest Medicaid billing hub in the state. 4 providers in AL appear on the OIG exclusion list.
| Code | Description | Total Paid |
|---|---|---|
| T2016 | Habilitation, residential, waiver; per diem | $1.83B |
| T1015 | Clinic visit/encounter, all-inclusive | $700.30M |
| T1019 | Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) | $627.87M |
MONTGOMERY ($4.55B) BIRMINGHAM ($1.25B) MOBILE ($453.69M) PRATTVILLE ($401.24M) HUNTSVILLE ($382.63M) SYLACAUGA ($324.42M) DOTHAN ($211.74M) TUSCALOOSA ($146.15M) ANNISTON ($109.08M) GADSDEN ($95.94M) DECATUR ($89.54M) MOUNT MEIGS ($81.97M) SELMA ($80.42M) CULLMAN ($75.20M) CENTREVILLE ($74.73M) FORT PAYNE ($68.76M) JASPER ($67.11M) FLORENCE ($66.15M) SCOTTSBORO ($59.44M) OPELIKA ($59.41M) HOMEWOOD ($54.52M) AUBURN ($53.69M) TROY ($52.32M) FAIRHOPE ($46.47M) BOAZ ($43.56M) VESTAVIA ($41.38M) HOOVER ($40.95M) TALLADEGA ($37.61M) BESSEMER ($36.76M) CENTRE ($36.31M) MADISON ($33.26M) NORTHPORT ($31.59M) ENTERPRISE ($31.48M) ALBERTVILLE ($30.89M) ATHENS ($30.44M) PELHAM ($30.13M) FOLEY ($29.74M) ALEXANDER CITY ($28.09M) ONEONTA ($27.62M) TUSCUMBIA ($26.71M) SHEFFIELD ($25.46M) PHENIX CITY ($25.14M) GARDENDALE ($24.87M) GREENVILLE ($23.45M) RUSSELLVILLE ($23.03M) PELL CITY ($22.66M) HUEYTOWN ($22.47M) DEMOPOLIS ($21.63M) ANDALUSIA ($21.18M) TRUSSVILLE ($20.78M)
Automated signals based on claims-per-beneficiary ratios, single-code concentration, and OIG exclusion status. These are statistical outliers — not evidence of fraud. Learn more
| # | Provider | Total Paid | Flags |
|---|---|---|---|
| 1 | STATE OF ALABAMA DEPT OF FINANCE | $98.59M | single-code billing |
| 2 | STATE OF ALABAMA DEPT OF FINANCE | $36.41M | single-code billing |
| 3 | MERCY LIFE OF ALABAMA | $11.50M | single-code billing |
| 4 | NEW BEACON HEALTHCARE GROUP, LLC | $11.02M | single-code billing |
| 5 | UNIVERSITY OF SOUTH ALABAMA | $7.37M | single-code billing |
| 6 | EH HEALTH HOSPICE OF ALABAMA, LLC | $7.17M | single-code billing |
| 7 | STATE OF ALABAMA DEPARTMENT OF FINANCE | $6.77M | single-code billing |
| 8 | NEW BEACON HEALTHCARE GROUP, LLC | $6.18M | single-code billing |
| 9 | NEW BEACON HEALTHCARE GROUP, LLC | $5.58M | single-code billing |
| 10 | GOOD SAMARITAN HOSPICE OF MADISON INC. | $5.22M | single-code billing |
| 11 | AFFINITY ACQUISITIONS, LLC | $4.84M | single-code billing |
| 12 | HC HEALTHCARE, LLC | $4.77M | single-code billing |
| 13 | STRATFORD ENTERPRISES INC | $4.70M | single-code billing |
| 14 | ALABAMA DEPARTMENT OF REHABILITATION SERVICES | $3.94M | single-code billing |
| 15 | PROHEALTH HOSPICE-ALABAMA, LLC | $3.84M | single-code billing |
| 16 | COMFORT CARE COASTAL HOSPICE, LLC | $3.37M | single-code billing |
| 17 | ALAHEALTH, INC. | $3.17M | single-code billing |
| 18 | ASERACARE HOSPICE - HAMILITON, LLC | $2.73M | single-code billing |
| 19 | AMEDISYS HOSPICE, L.L.C. | $2.26M | single-code billing |
| 20 | MOBILE COUNTY HEALTH DEPARTMENT EPSDT CM | $1.85M | single-code billing |
| 21 | JEFFERSON COUNTY HOME CARE EPSDT CC - ADPH | $1.62M | single-code billing |
| 22 | ALACARE HOME HEALTH SERVICES, INC. | $1.59M | single-code billing |
| 23 | COMFORT CARE HOSPICE, LLC | $1.59M | single-code billing |
| 24 | NEW BEACON HEALTHCARE GROUP, LLC | $1.51M | single-code billing |
| 25 | HOSPICE OF WEST ALABAMA, INC. | $1.42M | single-code billing |