Kentucky's 10,244 Medicaid providers billed $23.53B between 2018 and 2024. The most-billed code is S5108, accounting for $1.67B in payments. Louisville is the largest Medicaid billing hub in the state. 15 providers in KY appear on the OIG exclusion list.
| Code | Description | Total Paid |
|---|---|---|
| S5108 | Home care training to home care client, per 15 minutes | $1.67B |
| T2016 | Habilitation, residential, waiver; per diem | $1.66B |
| 97535 | Self-care/home management training, each 15 minutes | $1.12B |
LOUISVILLE ($5.22B) LEXINGTON ($2.52B) BOWLING GREEN ($1.02B) SOMERSET ($803.60M) ELIZABETHTOWN ($767.10M) OWENSBORO ($709.80M) ASHLAND ($701.27M) CORBIN ($584.13M) HAZARD ($554.09M) LONDON ($547.63M) PRESTONSBURG ($491.56M) PADUCAH ($426.25M) LOUISA ($403.08M) COVINGTON ($363.13M) DANVILLE ($357.62M) PIKEVILLE ($344.25M) MAYSVILLE ($318.82M) RICHMOND ($311.51M) FLORENCE ($291.45M) EDGEWOOD ($283.60M) HOPKINSVILLE ($242.23M) MOREHEAD ($226.93M) FRANKFORT ($217.57M) WINCHESTER ($217.28M) FORT THOMAS ($195.16M) GLASGOW ($192.48M) VERSAILLES ($192.34M) CAMPBELLSVILLE ($187.32M) GEORGETOWN ($181.90M) NICHOLASVILLE ($155.26M) WHITESBURG ($141.87M) ERLANGER ($135.68M) MAYFIELD ($129.85M) JACKSON ($128.08M) MADISONVILLE ($125.96M) HENDERSON ($113.88M) MANCHESTER ($100.64M) WILLISBURG ($98.52M) HARLAN ($97.57M) BARDSTOWN ($97.25M) MURRAY ($94.08M) PAINTSVILLE ($92.07M) BURKESVILLE ($88.42M) LEITCHFIELD ($84.99M) MIDDLESBORO ($84.39M) LEBANON ($83.11M) SHELBYVILLE ($80.89M) MT STERLING ($78.01M) COLUMBIA ($77.90M) CYNTHIANA ($77.35M)
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 | HEARTSONG MEMORY CARE, LLC | $24.05M | single-code billing |
| 2 | LABTOX, LLC | $21.75M | OIG excluded |
| 3 | MAXIM HEALTHCARE SERVICES INC. | $20.48M | single-code billing |
| 4 | BEHAVIORAL HEALTHCARE SERVICES, INC. | $18.06M | single-code billing |
| 5 | D&S RESIDENTIAL SERVICES, LP | $17.52M | single-code billing |
| 6 | COLUMBUS MEDICAL SERVICES, LLC | $12.13M | single-code billing |
| 7 | SOUTHERN HOME CARE SERVICES, INC. | $10.99M | single-code billing |
| 8 | ACSR, INC. | $10.33M | single-code billing |
| 9 | D&S RESIDENTIAL SERVICES, LP | $9.76M | single-code billing |
| 10 | DENTAL SURGICENTER OF LOUISVILLE LLC | $8.44M | single-code billing |
| 11 | KENNEDY INDIVIDUALIZED COMMUNITY SERVICES | $8.35M | single-code billing |
| 12 | DUNGARVIN KENTUCKY, LLC - BOWLING GREEN | $8.12M | single-code billing |
| 13 | DUNGARVIN KENTUCKY, LLC - LOUISVILLE | $7.49M | single-code billing |
| 14 | A1 CASE MANAGEMENT | $7.07M | single-code billing |
| 15 | COMMONWEALTH HEALTH CORPORATION | $6.78M | single-code billing |
| 16 | BLUE SKY CASE MANAGEMENT, LLC | $6.74M | single-code billing |
| 17 | RIVERVALLEY BEHAVIORAL HEALTH INC | $6.60M | single-code billing |
| 18 | DUNGARVIN KENTUCKY, LLC - OWENSBORO | $5.78M | single-code billing |
| 19 | ABILITY, LLC | $5.69M | single-code billing |
| 20 | BAWAC, INC. | $5.50M | single-code billing |
| 21 | REACH FOR THE STARS CASE MANAGEMENT | $5.43M | single-code billing |
| 22 | T.A.C.K. FOR LIFE | $5.16M | single-code billing |
| 23 | C.A.N. HELP, INC | $4.82M | single-code billing |
| 24 | SERNA, CARLOS | $4.29M | single-code billing |
| 25 | CASE MANAGMENT OPTIONS OF KENTUCKY | $3.91M | single-code billing |
| # | Provider | City | Claims | Total Paid |
|---|---|---|---|---|
| 1 | UNIVERSITY OF KENTUCKY | LEXINGTON | 8,817,197 | $716.41M |
| 2 | NORTON HOSPITALS INC | LOUISVILLE | 5,948,130 | $419.58M |
| 3 | SEVEN COUNTIES SERVICES, INC. | LOUISVILLE | 2,713,342 | $375.84M |
| 4 | CUMBERLAND RIVER BEHAVIORAL HEALTH, INC | CORBIN | 2,742,266 | $349.24M |
| 5 | ADDICTION RECOVERY CARE LLC | LOUISA | 2,428,894 | $308.96M |
| 6 | NORTON HOSPITALS, INC | LOUISVILLE | 3,175,044 | $299.00M |
| 7 | UOFL HEALTH-LOUISVILLE INC | LOUISVILLE | 4,469,131 | $283.15M |
| 8 | MOUNTAIN COMPREHENSIVE CARE CENTER, INC. | PRESTONSBURG | 2,626,038 | $243.11M |
| 9 | ASHLAND HOSPITAL CORPORATION | ASHLAND | 6,507,603 | $222.76M |
| 10 | SOUTHEASTERN EMERGENCY PHYSICIANS LLC | MAYSVILLE | 4,194,505 | $208.94M |
| 11 | COMMUNICARE INC | ELIZABETHTOWN | 1,847,621 | $206.11M |
| 12 | SEVEN COUNTIES SERVICES, INC. | LOUISVILLE | 2,375,545 | $194.18M |
| 13 | ST ELIZABETH MEDICAL CENTER, INC | EDGEWOOD | 4,271,419 | $188.25M |
| 14 | PIKEVILLE MEDICAL CENTER INC | PIKEVILLE | 4,310,485 | $181.38M |
| 15 | UNIVERSITY MEDICAL CENTER, INC | LOUISVILLE | 2,408,658 | $179.41M |
| 16 | LIFESKILLS, INC | BOWLING GREEN | 1,424,348 | $168.89M |
| 17 | NEW VISTA OF THE BLUEGRASS INC | VERSAILLES | 1,263,610 | $166.38M |
| 18 | SPERO HEALTH OF KENTUCKY, LLC | DANVILLE | 2,613,987 | $154.25M |
| 19 | OWENSBORO HEALTH INC | OWENSBORO | 3,299,869 | $148.83M |
| 20 | FREEDOM SENIOR SHARE, LLC | LOUISVILLE | 1,109,021 | $142.70M |
| 21 | LAKE CUMBERLAND REG MHMR BOARD, INC. | SOMERSET | 899,040 | $140.90M |
| 22 | COMMUNITY MEDICAL ASSOCIATES, INC. | LOUISVILLE | 5,158,011 | $135.33M |
| 23 | PERSONAL TOUCH HOME CARE OF KY, INC. | FORT THOMAS | 357,881 | $127.23M |
| 24 | BAPTIST HEALTHCARE SYSTEM, INC | CORBIN | 2,489,029 | $121.50M |
| 25 | GRAVITY DIAGNOSTICS, LLC | COVINGTON | 3,771,600 | $116.16M |
| 26 | BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION | BOWLING GREEN | 2,106,315 | $112.19M |
| 27 | KENTUCKY MEDICAL SERVICES FOUNDATION, INC | LEXINGTON | 2,925,950 | $110.27M |
| 28 | KENTUCKY RIVER COMMUNITY CARE, INC | HAZARD | 874,597 | $109.24M |
| 29 | KYPPEC,INC | LOUISVILLE | 523,657 | $109.16M |
| 30 | APPALACHIAN REGIONAL HEALTHCARE, INC. | HAZARD | 1,905,556 | $107.94M |
| 31 | NORTON CHILDRENS MEDICAL GROUP, LLC | LOUISVILLE | 3,157,297 | $107.36M |
| 32 | KENTUCKY RIVER COMMUNITY CARE, INC | HAZARD | 1,091,883 | $104.05M |
| 33 | AMERICAN HEALTH MANAGEMENT, INC. | RICHMOND | 724,472 | $99.38M |
| 34 | GREEN RIVER REGIONAL MENTAL HEALTH/MENTAL RETARDATION BOARD, INC. | OWENSBORO | 952,265 | $98.78M |
| 35 | BAPTIST HEALTHCARE SYSTEM, INC | LEXINGTON | 2,179,531 | $98.07M |
| 36 | T J SAMSON COMMUNITY HOSPITAL | GLASGOW | 2,471,139 | $95.74M |
| 37 | BAPTIST HEALTHCARE SYSTEM INC | ELIZABETHTOWN | 1,819,634 | $95.61M |
| 38 | PATHWAYS, INC. | ASHLAND | 828,998 | $95.51M |
| 39 | SUMMIT MEDICAL GROUP, INC | ERLANGER | 2,550,874 | $94.78M |
| 40 | ISAIAH HOUSE, INC. | WILLISBURG | 532,833 | $94.70M |
| 41 | GREEN RIVER AREA DEVELOPMENT DISTRICT | OWENSBORO | 701,636 | $93.09M |
| 42 | LIFESKILLS, INC. | HOPKINSVILLE | 763,636 | $88.04M |
| 43 | SAINT JOSEPH HEALTH SYSTEM, INC | LEXINGTON | 1,192,706 | $85.54M |
| 44 | KENTUCKY HOSPITAL, LLC | WINCHESTER | 1,466,518 | $83.74M |
| 45 | SAINT JOSEPH HEALTH SYSTEM, INC | LONDON | 1,699,447 | $83.71M |
| 46 | PATHWAYS INC | ASHLAND | 1,293,199 | $82.16M |
| 47 | EDWARDS HEALTH CARE SERVICES, INC. | LOUISVILLE | 535,131 | $81.90M |
| 48 | LIFESKILLS, INC. | BOWLING GREEN | 735,719 | $81.84M |
| 49 | BAPTIST HEALTH DEACONESS MADISONVILLE INC | MADISONVILLE | 1,716,876 | $80.89M |
| 50 | FOREVER CARE DBA INDEPENDENT OPPORTUNITIES | LONDON | 437,033 | $78.93M |
| 51 | BUENA VIDA ADHC, LLC | LOUISVILLE | 520,851 | $78.36M |
| 52 | GRAVES GILBERT CLINIC PLLC | BOWLING GREEN | 2,734,378 | $78.28M |
| 53 | LAKE CUMBERLAND REGIONAL HOSPITAL LLC | SOMERSET | 1,511,966 | $77.77M |
| 54 | ACTIVE DAY KY, INC. | LOUISVILLE | 614,128 | $75.52M |
| 55 | BLUEGRASS AREA DEVELOPMENT DISTRICT | LEXINGTON | 479,960 | $75.41M |
| 56 | BAPTIST HEALTHCARE SYSTEM, INC | PADUCAH | 1,523,785 | $72.57M |
| 57 | CUMBERLAND FAMILY MEDICAL CENTER INC | BURKESVILLE | 2,678,733 | $72.46M |
| 58 | ST CLAIRE MEDICAL CENTER INC | MOREHEAD | 1,862,443 | $71.27M |
| 59 | ACCESS ADULT HEALTH DAY CARE CENTER | LOUISVILLE | 479,234 | $71.01M |
| 60 | NEW VISTA OF THE BLUEGRASS INC | FRANKFORT | 877,185 | $69.64M |
| 61 | NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARD | COVINGTON | 611,265 | $68.45M |
| 62 | STEPWORKS RECOVERY CENTERS LLC | ELIZABETHTOWN | 182,231 | $67.74M |
| 63 | SAINT JOSEPH HEALTH SYSTEM, INC | LEXINGTON | 1,142,880 | $67.41M |
| 64 | ST ELIZABETH MEDICAL CENTER, INC | FLORENCE | 1,144,433 | $65.44M |
| 65 | BLUEGRASS AREA DEVELOPMENT DISTRICT | LEXINGTON | 588,935 | $65.24M |
| 66 | MOUNTAIN COMPREHENSIVE CARE CENTER | PRESTONSBURG | 687,116 | $65.03M |
| 67 | BROCK MEDICAL, LLC | LONDON | 1,656,561 | $63.70M |
| 68 | EMPLOYMENT SOLUTIONS INC | LEXINGTON | 496,174 | $62.66M |
| 69 | MOUNTAIN COMPREHENSIVE HEALTH CORPORATION | WHITESBURG | 3,197,641 | $62.46M |
| 70 | BAPTIST HEALTHCARE SYSTEM INC. | LOUISVILLE | 1,172,497 | $62.41M |
| 71 | MERCY HEALTH-LOURDES HOSPITAL LLC | PADUCAH | 1,524,507 | $61.89M |
| 72 | CLINICAL ASSOCIATES, LLC | LOUISVILLE | 2,700,271 | $60.75M |
| 73 | RK, ADC, LLC | LOUISVILLE | 456,684 | $60.33M |
| 74 | EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED | DANVILLE | 1,036,528 | $59.95M |
| 75 | BAPTIST HEALTHCARE SYSTEM, INC. | RICHMOND | 1,065,942 | $58.51M |
| 76 | BIG SANDY AREA AGENCY ON AGING | PRESTONSBURG | 368,916 | $56.10M |
| 77 | AFTON COMMUNIY DAY, INC. | LEXINGTON | 329,204 | $55.97M |
| 78 | KEYSTONE SERVICES, INC DBA | LOUISVILLE | 365,128 | $55.49M |
| 79 | APPALACHIAN REGIONAL HEALTHCARE, INC. | HARLAN | 968,194 | $55.19M |
| 80 | DISTRICT 4 CDO PROGRAM | BOWLING GREEN | 451,813 | $54.91M |
| 81 | MORRLAND HEALTHCARE LLC | SOMERSET | 506,523 | $54.82M |
| 82 | BAPTIST HEALTH MEDICAL GROUP INC | LEXINGTON | 1,658,790 | $54.04M |
| 83 | NORTHERN KENTUCKY MENTAL HEALTH MENTAL RETARDATION REGIONAL BOARD | COVINGTON | 786,832 | $53.33M |
| 84 | GOLDEN YEARS ADULT DAY CARE | EDMONTON | 271,185 | $53.08M |
| 85 | CENTER FOR COMPREHENSIVE SERVICES, INC DBA NEURORESTORATIVE KENTUCKY | LOUISVILLE | 339,713 | $52.84M |
| 86 | NORTHERN KENTUCKY CONSUMER DIRECTED OPTIONS PROGRAM | FLORENCE | 435,350 | $52.63M |
| 87 | ENCORE ADHC, LLC | LEXINGTON | 354,801 | $51.98M |
| 88 | METHODIST HEALTH, INC. | HENDERSON | 1,024,834 | $51.09M |
| 89 | JENNIE STUART MEDICAL CENTER INC | HOPKINSVILLE | 1,523,068 | $50.76M |
| 90 | EDGEWATER RECOVERY CENTER LLC | MOREHEAD | 435,551 | $50.22M |
| 91 | COMMUNICARE INC | ELIZABETHTOWN | 476,605 | $49.47M |
| 92 | GREENVIEW HOSPITAL, INC. | BOWLING GREEN | 833,903 | $49.12M |
| 93 | COMMUNITY MEDICAL ASSOCIATES, INC. | LOUISVILLE | 894,867 | $48.97M |
| 94 | THE COMMITMENT HOUSE LLC | ELIZABETHTOWN | 263,137 | $48.97M |
| 95 | CENTER FOR COMPREHENSIVE SERVICES, INC | PADUCAH | 297,485 | $47.71M |
| 96 | KENTUCKINANA REGIONAL PLANNING AND DEVELOPMENT AGENCY | LOUISVILLE | 411,576 | $47.35M |
| 97 | MEMORIAL HOSPITAL, INC. | MANCHESTER | 1,223,093 | $46.83M |
| 98 | ARROW DENTAL PLLC | LEXINGTON | 1,210,262 | $46.75M |
| 99 | ST ELIZABETH MEDICAL CENTER, INC | FORT THOMAS | 696,134 | $45.99M |
| 100 | GEORGETOWN COMMUNITY HOSPITAL LLC | GEORGETOWN | 796,831 | $44.03M |