Medicaid spending in Kentucky

1. Agencies — home care, case management, community support
   19¢
2. Clinics and outpatient centers
   17¢
3. Hospitals (outpatient claims only)
   13¢
4. Counselors, therapists and social workers
   11¢
5. Physicians
   9¢
6. Residential treatment
   6¢
7. Nurse practitioners and physician assistants
   4¢
8. Rides and ambulances
   4¢

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

1. S5108Home care training to home care client, per 15 minutes
   $1.7B
2. T2016A day of residential support for a person with a developmental disability
   $1.7B
3. 97535Self-care/home management training, each 15 minutes
   $1.1B
4. 99213Doctor's office visit, returning patient (routine)
   $991M
5. 99284Emergency room visit (serious)
   $859M
6. 99285Emergency room visit (most serious)
   $611M
7. 99214Doctor's office visit, returning patient (more involved)
   $604M
8. 90837Psychotherapy session, about an hour
   $566M
9. T1019Help at home with bathing, dressing and eating, billed per 15 minutes
   $565M
10. 99283Emergency room visit (moderate)
    $565M

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