Medicaid spending in Tennessee

1. Agencies — home care, case management, community support
   39¢
2. Physicians
   14¢
3. Clinics and outpatient centers
   13¢
4. Hospitals (outpatient claims only)
   6¢
5. Residential treatment
   5¢
6. Medical equipment and supplies
   4¢
7. Dentists
   4¢
8. Counselors, therapists and social workers
   4¢

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

1. T2033Residential care, not otherwise specified (nos), waiver; per diem
   $3.0B
2. T2023Targeted case management; per month
   $1.1B
3. S0280Medical home program, comprehensive care coordination and planning, initial plan
   $853M
4. 99214Doctor's office visit, returning patient (more involved)
   $761M
5. T1019Help at home with bathing, dressing and eating, billed per 15 minutes
   $760M
6. 99213Doctor's office visit, returning patient (routine)
   $745M
7. 99284Emergency room visit (serious)
   $684M
8. S5125Attendant care at home, billed per 15 minutes
   $603M
9. 99283Emergency room visit (moderate)
   $542M
10. T2016A day of residential support for a person with a developmental disability
    $533M

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