Medicaid spending in South Dakota

1. Agencies — home care, case management, community support
   27¢
2. Clinics and outpatient centers
   25¢
3. Residential treatment
   17¢
4. Physicians
   9¢
5. Counselors, therapists and social workers
   4¢
6. Dentists
   3¢
7. Hospitals (outpatient claims only)
   3¢
8. Rides and ambulances
   2¢

Cents of every dollar billed by South Dakota-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
   $663M
2. T2048Behavioral health; long-term care residential (non-acute care in a residential treatment program where stay is typically longer than 30 days), with room and board, per diem
   $186M
3. T2020Day habilitation, waiver; per diem
   $178M
4. 99213Doctor's office visit, returning patient (routine)
   $176M
5. S0281Medical home program, comprehensive care coordination and planning, maintenance of plan
   $63M
6. 99214Doctor's office visit, returning patient (more involved)
   $58M
7. T2031Assisted living; waiver, per diem
   $46M
8. H2016Community support for mental illness or disability, billed per day
   $40M
9. H2021Community-based wrap-around services, per 15 minutes
   $39M
10. T2025Waiver services not otherwise specified
    $35M

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