South Carolina
#27 in Medicaid spending (0.95% of national total)
Total Spending
$10.34B
Total Claims
204.6M
Providers
8,111
Avg Cost/Claim
$51
Data Coverage Note: South Carolina has 60% of Medicaid enrollees in managed care. This data covers only fee-for-service (FFS) claims (est. 40% of enrollees). Actual total Medicaid spending in South Carolina is significantly higher than shown.
Enrollment (Latest)
1.4M
Managed Care
60%
ACA Expansion
Not Expanded
FFS $/Enrollee
$1,219
Yearly Spending Trend
Year-over-Year Growth
Top Providers
| Provider | Total Paid▼ |
|---|---|
MEDICAL UNIVERSITY HOSPITAL AUTHORITY General Acute Care Hospital | $241.4M |
SPARTANBURG MEDICAL CENTER Ambulance | $187.8M |
PRISMA HEALTH UNIVERSITY MEDICAL GROUP Internal Medicine | $172.2M |
AXCESS HEALTHCARE SERVICES, LLC Nursing Care | $98.8M |
PALMETTO INFUSION SERVICES LLC Clinic/Center | $93.6M |
MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC. General Acute Care Hospital | $90.9M |
NIGHTINGALE'S NURSING & ATTENDANT CARE SERVICES, INC. Home Health | $89.7M |
PRISMA HEALTH-UPSTATE General Acute Care Hospital | $86.9M |
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. Social Worker | $84.5M |
ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC Physician Assistant | $81.3M |
PRISMA HEALTH MEDICAL GROUP-MIDLANDS Dentist | $77.8M |
ANMED HEALTH Speech-Language Pathologist | $75.8M |
BABCOCK CENTER, INC. Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $75.8M |
CHESCO SERVICES Early Intervention Provider Agency | $75.5M |
PRISMA HEALTH-MIDLANDS General Acute Care Hospital | $74.6M |
THE CHARLES LEA CENTER INC. Case Management | $70.4M |
DENTISTRY FOR CHILDREN OF SOUTH CAROLINA, PC Dentist | $68.5M |
PRISMA HEALTH-MIDLANDS General Acute Care Hospital | $68.3M |
SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE Clinic/Center | $65.9M |
SOUTH CAROLINA YOUTH ADVOCATE PROGRAM Community/Behavioral Health | $64.1M |
20 rows
Top Procedures
| Code | Description | Total Paid▼ |
|---|---|---|
| T2016 | Habil res waiver per diem | $801.3M |
| 99213 | Office o/p est low 20 min | $703.8M |
| 99214 | Office o/p est mod 30 min | $610.9M |
| T1019 | Personal care ser per 15 min | $443.0M |
| 90837 | Psytx w pt 60 minutes | $267.1M |
| T2046 | Hospice long term care, r&b | $249.5M |
| 92507 | Tx sp lang voice comm indiv | $241.9M |
| 97530 | Therapeutic activities | $190.0M |
| T1015 | Clinic service | $185.6M |
| 36415 | Coll venous bld venipuncture | $176.3M |
| 99284 | Emergency dept visit mod mdm | $157.8M |
| 99283 | Emergency dept visit low mdm | $153.6M |
| 90834 | Psytx w pt 45 minutes | $148.0M |
| 80053 | Comprehen metabolic panel | $130.4M |
| 97110 | Therapeutic exercises | $118.1M |
| H0031 | Mh health assess by non-md | $97.5M |
| S5102 | Adult day care per diem | $91.2M |
| 99285 | Emergency dept visit hi mdm | $88.2M |
| 92508 | Tx sp lang voice comm group | $85.9M |
| 99392 | Prev visit est age 1-4 | $85.5M |
20 rows
Provider Classification Breakdown
| Classification | Total Paid▼ | Providers |
|---|---|---|
| Clinic/Center | $1.53B | 760 |
| General Acute Care Hospital | $1.39B | 128 |
| Dentist | $726.3M | 679 |
| Pediatrics | $557.4M | 568 |
| Internal Medicine | $382.7M | 562 |
| Nursing Care | $330.9M | 39 |
| Ambulance | $330.8M | 113 |
| Durable Medical Equipment & Medical Supplies | $320.9M | 232 |
| Early Intervention Provider Agency | $307.9M | 52 |
| Hospice Care, Community Based | $299.9M | 36 |
| Case Management | $287.7M | 45 |
| Home Health | $253.6M | 93 |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $249.8M | 10 |
| Community/Behavioral Health | $230.1M | 79 |
| Local Education Agency (LEA) | $229.4M | 77 |
| Counselor | $225.0M | 404 |
| Speech-Language Pathologist | $206.3M | 163 |
| Family Medicine | $178.2M | 735 |
| Occupational Therapist | $133.7M | 80 |
| Emergency Medicine | $132.9M | 280 |