Medicaid spending in Utah

1. Counselors, therapists and social workers
   18¢
2. Clinics and outpatient centers
   15¢
3. Physicians
   13¢
4. Agencies — home care, case management, community support
   12¢
5. Rides and ambulances
   10¢
6. Hospital Units
   7¢
7. Laboratories
   5¢
8. Hospitals (outpatient claims only)
   5¢

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

1. 8888888Internal/system code - not a standard HCPCS code
   $543M
2. 90837Psychotherapy session, about an hour
   $262M
3. 97153Applied behavior analysis (autism therapy), per 15 minutes
   $253M
4. A0429Emergency ambulance ride, basic life support
   $200M
5. 99214Doctor's office visit, returning patient (more involved)
   $193M
6. H0018Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem
   $174M
7. 99213Doctor's office visit, returning patient (routine)
   $169M
8. A0380Bls mileage (per mile)
   $113M
9. 90853Group psychotherapy (other than of a multiple-family group)
   $79M
10. T1000Private duty / independent nursing service(s) - licensed, up to 15 minutes
    $78M

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