Medicaid spending in Iowa

1. Agencies — home care, case management, community support
   31¢
2. Clinics and outpatient centers
   13¢
3. Residential treatment
   13¢
4. Dietary & Nutritional Service Providers
   8¢
5. Physicians
   8¢
6. Counselors, therapists and social workers
   6¢
7. Hospitals (outpatient claims only)
   4¢
8. Rides and ambulances
   4¢

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

1. H2016Community support for mental illness or disability, billed per day
   $2.7B
2. S5136Companion care, adult (e.g., iadl/adl); per diem
   $1.5B
3. T1015A visit at a community health center or clinic (one all-in rate)
   $932M
4. S5170Home delivered meals, including preparation; per meal
   $883M
5. T2020Day habilitation, waiver; per diem
   $308M
6. 90834Psychotherapy session, about 45 minutes
   $232M
7. 99284Emergency room visit (serious)
   $223M
8. 99490Ccm add 20min
   $217M
9. 99213Doctor's office visit, returning patient (routine)
   $202M
10. G0463Hospital outpatient clinic visit for assessment and management of a patient
    $198M

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