Medicaid spending in West Virginia

1. Agencies — home care, case management, community support
   26¢
2. Clinics and outpatient centers
   18¢
3. Physicians
   14¢
4. Hospitals (outpatient claims only)
   13¢
5. Laboratories
   5¢
6. Rides and ambulances
   5¢
7. Counselors, therapists and social workers
   4¢
8. Residential treatment
   4¢

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

1. S5125Attendant care at home, billed per 15 minutes
   $1.3B
2. T1015A visit at a community health center or clinic (one all-in rate)
   $860M
3. S5130Homemaker services, billed per 15 minutes
   $476M
4. T1019Help at home with bathing, dressing and eating, billed per 15 minutes
   $365M
5. 99213Doctor's office visit, returning patient (routine)
   $314M
6. H2036Alcohol and/or other drug treatment program, per diem
   $273M
7. H0004Behavioral health counseling and therapy, per 15 minutes
   $247M
8. 99214Doctor's office visit, returning patient (more involved)
   $229M
9. 99285Emergency room visit (most serious)
   $192M
10. 99284Emergency room visit (serious)
    $186M

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