Montana
#42 in Medicaid spending (0.49% of national total)
Total Spending
$5.37B
Total Claims
74.8M
Providers
3,426
Avg Cost/Claim
$72
Data Coverage Note: Montana has 82% of Medicaid enrollees in managed care. This data covers only fee-for-service (FFS) claims (est. 18% of enrollees). Actual total Medicaid spending in Montana is significantly higher than shown.
Enrollment (Latest)
226K
Managed Care
82%
ACA Expansion
Yes (2016)
FFS $/Enrollee
$4,229
Yearly Spending Trend
Year-over-Year Growth
Top Providers
| Provider | Total Paid▼ |
|---|---|
CONSUMER DIRECT CARE NETWORK VIRGINIA Case Manager/Care Coordinator | $2.11B |
CONSUMER DIRECT DISTRICT OF COLUMBIA Home Health | $392.7M |
AWARE INC Behavior Analyst | $140.4M |
WESTERN MONTANA MENTAL HEALTH CENTER Counselor | $87.9M |
YOUTH DYNAMICS, INC. Respite Care | $65.3M |
CENTER FOR MENTAL HEALTH Counselor | $55.2M |
BILLINGS CLINIC Allergy & Immunology | $53.9M |
CONSUMER DIRECT PERSONAL CARE, LLC Community/Behavioral Health | $49.0M |
OPPORTUNITY RESOURCES INC Day Training, Developmentally Disabled Services | $48.6M |
RIMROCK FOUNDATION Social Worker | $44.9M |
FLATHEAD INDUSTRIES Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $40.7M |
BENEFIS HOSPITALS INC Specialist | $38.2M |
CAPITAL OPPORTUNTIES, INC. Community/Behavioral Health | $37.8M |
WEST MONT Custodial Care Facility | $34.7M |
MISSOULA DEVELOPMENTAL SERVICE CORP Day Training, Developmentally Disabled Services | $33.6M |
SCL HEALTH MEDICAL GROUP - BILLINGS LLC General Practice | $32.1M |
RESIDENTIAL SUPPORT SERVICES Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $30.6M |
A PLUS HEALTH CARE INC Case Management | $28.2M |
NEW DAY, INC. Case Management | $27.7M |
QUALITY LIFE CONCEPTS INC. Community/Behavioral Health | $26.0M |
20 rows
Top Procedures
| Code | Description | Total Paid▼ |
|---|---|---|
| S5126 | Attendant care service /diem | $1.78B |
| T1019 | Personal care ser per 15 min | $553.0M |
| T2017 | Habil res waiver 15 min | $276.9M |
| S5150 | Unskilled respite care /15m | $234.0M |
| 90837 | Psytx w pt 60 minutes | $172.4M |
| H0036 | Comm psy face-face per 15min | $147.1M |
| 99214 | Office o/p est mod 30 min | $119.6M |
| T2021 | Day habil waiver per 15 min | $118.1M |
| 99213 | Office o/p est low 20 min | $102.8M |
| S5145 | Child fostercare th per diem | $98.5M |
| S5136 | Adult companioncare per diem | $93.9M |
| T2031 | Assist living waiver/diem | $89.3M |
| T2013 | Habil ed waiver per hour | $87.6M |
| T1016 | Case management | $73.8M |
| H0018 | Alcohol and/or drug services | $61.7M |
| S5102 | Adult day care per diem | $57.4M |
| H0040 | Assert comm tx pgm per diem | $55.0M |
| T2022 | Case management, per month | $54.7M |
| 97530 | Therapeutic activities | $40.6M |
| 99284 | Emergency dept visit mod mdm | $35.3M |
20 rows
Provider Classification Breakdown
| Classification | Total Paid▼ | Providers |
|---|---|---|
| Case Manager/Care Coordinator | $2.11B | 3 |
| Home Health | $422.8M | 13 |
| Counselor | $301.6M | 697 |
| Day Training, Developmentally Disabled Services | $256.5M | 26 |
| Clinic/Center | $210.5M | 393 |
| Dentist | $199.6M | 321 |
| Community/Behavioral Health | $196.5M | 44 |
| Case Management | $149.2M | 29 |
| Behavior Analyst | $147.2M | 7 |
| Local Education Agency (LEA) | $145.3M | 102 |
| Social Worker | $123.2M | 373 |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $102.2M | 5 |
| Assisted Living Facility | $73.6M | 31 |
| Respite Care | $65.3M | 2 |
| Specialist | $60.9M | 22 |
| Durable Medical Equipment & Medical Supplies | $59.7M | 146 |
| Psychiatry & Neurology | $57.6M | 28 |
| Ambulance | $56.7M | 56 |
| Allergy & Immunology | $54.4M | 3 |
| Emergency Medicine | $40.2M | 14 |