Medicaid spending in Maine

1. Agencies — home care, case management, community support
   39¢
2. Residential treatment
   23¢
3. Clinics and outpatient centers
   8¢
4. Hospitals (outpatient claims only)
   8¢
5. Physicians
   5¢
6. Counselors, therapists and social workers
   4¢
7. Respiratory, Developmental, Rehabilitative and Restorative Service Providers
   3¢
8. Medical equipment and supplies
   2¢

Cents of every dollar billed by Maine-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
   $2.3B
2. H0019Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem
   $670M
3. T1015A visit at a community health center or clinic (one all-in rate)
   $545M
4. H2021Community-based wrap-around services, per 15 minutes
   $534M
5. T1019Help at home with bathing, dressing and eating, billed per 15 minutes
   $513M
6. S5140Foster care, adult; per diem
   $421M
7. T2021Day program for adults with developmental disabilities, per 15 minutes
   $370M
8. G0463Hospital outpatient clinic visit for assessment and management of a patient
   $252M
9. H0004Behavioral health counseling and therapy, per 15 minutes
   $233M
10. H2012Behavioral health day treatment, per hour
    $212M

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