Medicaid spending in Delaware

1. Counselors, therapists and social workers
   34¢
2. Clinics and outpatient centers
   17¢
3. Agencies — home care, case management, community support
   16¢
4. Physicians
   10¢
5. Hospitals (outpatient claims only)
   9¢
6. Dentists
   6¢
7. Other Service Providers
   1¢
8. Nursing Service Related Providers
   1¢

Cents of every dollar billed by Delaware-based providers, grouped by each provider's primary NPPES type. Compare: nationally, agencies take 33¢ and physicians 11¢.

1. S5130Homemaker services, billed per 15 minutes
   $531M
2. T2025Waiver services not otherwise specified
   $508M
3. T2016A day of residential support for a person with a developmental disability
   $205M
4. S9124Nursing care, in the home; by licensed practical nurse, per hour
   $177M
5. 99214Doctor's office visit, returning patient (more involved)
   $118M
6. 99213Doctor's office visit, returning patient (routine)
   $100M
7. S5125Attendant care at home, billed per 15 minutes
   $100M
8. 99283Emergency room visit (moderate)
   $88M
9. S9123Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)
   $75M
10. T2020Day habilitation, waiver; per diem
    $70M

Statistical outliers on claims per beneficiary, single-code billing, and OIG exclusion. Not evidence of fraud — how these work.