Medicaid spending in Massachusetts

1. Agencies — home care, case management, community support
   58¢
2. Clinics and outpatient centers
   12¢
3. Hospitals (outpatient claims only)
   9¢
4. Physicians
   5¢
5. Counselors, therapists and social workers
   3¢
6. Nursing and custodial care facilities
   3¢
7. Dentists
   2¢
8. Medical equipment and supplies
   2¢

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

1. T2016A day of residential support for a person with a developmental disability
   $9.0B
2. T1019Help at home with bathing, dressing and eating, billed per 15 minutes
   $8.4B
3. S5140Foster care, adult; per diem
   $3.1B
4. S5102Adult day care, billed per day
   $1.4B
5. 99214Doctor's office visit, returning patient (more involved)
   $1.1B
6. 90834Psychotherapy session, about 45 minutes
   $970M
7. T1502Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit
   $952M
8. 99213Doctor's office visit, returning patient (routine)
   $873M
9. T2025Waiver services not otherwise specified
   $865M
10. T1015A visit at a community health center or clinic (one all-in rate)
    $852M

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