Rhode Island
#37 in Medicaid spending (0.63% of national total)
Total Spending
$6.93B
Total Claims
71.2M
Providers
6,067
Avg Cost/Claim
$97
Data Coverage Note: Rhode Island has 99% of Medicaid enrollees in managed care. This data covers only fee-for-service (FFS) claims (est. 1% of enrollees). Actual total Medicaid spending in Rhode Island is significantly higher than shown.
Enrollment (Latest)
313K
Managed Care
99%
ACA Expansion
Yes (2014)
FFS $/Enrollee
$3,629
Yearly Spending Trend
Year-over-Year Growth
Top Providers
| Provider | Total Paid▼ |
|---|---|
RHODE ISLAND HOSPITAL General Acute Care Hospital | $380.8M |
DOMINION DIAGNOSTICS, LLC Clinical Medical Laboratory | $249.2M |
THE FOGARTY CENTER Day Training, Developmentally Disabled Services | $224.3M |
PERSPECTIVES CORPORATION Day Training, Developmentally Disabled Services | $182.9M |
THE PROVIDENCE CENTER INC Counselor | $170.8M |
WEST BAY RESIDENTIAL SERVICES INC. Day Training, Developmentally Disabled Services | $145.8M |
THE MIRIAM HOSPITAL General Acute Care Hospital | $138.6M |
LOOKING UPWARDS, INC. Day Training, Developmentally Disabled Services | $136.3M |
WOMEN & INFANTS HOSPITAL OF RHODE ISLAND Clinic/Center | $132.2M |
GATEWAY HEALTHCARE INC Day Training, Developmentally Disabled Services | $122.9M |
THE FOGARTY CENTER In Home Supportive Care | $110.0M |
RE-FOCUS INC. Day Training, Developmentally Disabled Services | $102.5M |
KENT COUNTY MEMORIAL HOSPITAL Internal Medicine | $90.8M |
SEVEN HILLS RHODE ISLAND Day Training, Developmentally Disabled Services | $84.0M |
THE ARC OF BALCKSTONE VALLEY Day Training, Developmentally Disabled Services | $83.6M |
A CARING EXPERIENCE NURSING SERVICES, INC. Home Health | $78.5M |
JOY HOME CARE INC. Home Health | $75.4M |
AVATAR RESIDENTIAL, INC. Day Training, Developmentally Disabled Services | $72.9M |
THRIVE BEHAVIORAL HEALTH, INC. Community Health Worker | $71.9M |
HOPE NURSING HOME CARE, LLC Home Health | $70.7M |
20 rows
Top Procedures
| Code | Description | Total Paid▼ |
|---|---|---|
| T2033 | Res, nos waiver per diem | $877.4M |
| S5125 | Attendant care service /15m | $650.8M |
| T2017 | Habil res waiver 15 min | $381.6M |
| T2021 | Day habil waiver per 15 min | $330.6M |
| H0019 | Alcohol and/or drug services | $242.7M |
| H0037 | Comm psy sup tx pgm per diem | $218.0M |
| T1019 | Personal care ser per 15 min | $171.7M |
| 99213 | Office o/p est low 20 min | $148.2M |
| T2046 | Hospice long term care, r&b | $146.3M |
| 80307 | Drug test prsmv chem anlyzr | $134.9M |
| 99214 | Office o/p est mod 30 min | $129.0M |
| H0040 | Assert comm tx pgm per diem | $126.3M |
| H0020 | Alcohol and/or drug services | $119.5M |
| T1015 | Clinic service | $111.2M |
| G0480 | Drug test def 1-7 classes | $95.6M |
| 99284 | Emergency dept visit mod mdm | $89.9M |
| T1024 | Team evaluation & management | $88.6M |
| 99285 | Emergency dept visit hi mdm | $80.8M |
| S5102 | Adult day care per diem | $77.2M |
| T2031 | Assist living waiver/diem | $72.3M |
20 rows
Provider Classification Breakdown
| Classification | Total Paid▼ | Providers |
|---|---|---|
| Day Training, Developmentally Disabled Services | $1.69B | 34 |
| General Acute Care Hospital | $647.9M | 11 |
| Home Health | $551.1M | 43 |
| Clinic/Center | $508.5M | 146 |
| Clinical Medical Laboratory | $307.6M | 6 |
| Counselor | $277.3M | 468 |
| Case Management | $271.1M | 25 |
| Internal Medicine | $203.0M | 645 |
| Community/Behavioral Health | $193.2M | 51 |
| Nursing Care | $187.5M | 11 |
| Dentist | $166.3M | 239 |
| In Home Supportive Care | $147.1M | 6 |
| Hospice Care, Community Based | $127.4M | 8 |
| Durable Medical Equipment & Medical Supplies | $110.4M | 35 |
| Pediatrics | $97.6M | 341 |
| Psychologist | $83.0M | 104 |
| Community Health Worker | $74.9M | 3 |
| Local Education Agency (LEA) | $74.7M | 72 |
| Emergency Medicine | $73.5M | 206 |
| Social Worker | $71.6M | 400 |