South Dakota

#49 in Medicaid spending (0.23% of national total)

Total Spending

$2.51B

Total Claims

22.6M

Providers

1,663

Avg Cost/Claim

$111

Data Coverage Note: South Dakota has 74% of Medicaid enrollees in managed care. This data covers only fee-for-service (FFS) claims (est. 26% of enrollees). Actual total Medicaid spending in South Dakota is significantly higher than shown.

Enrollment (Latest)

127K

Managed Care

74%

ACA Expansion

Yes (2023)

FFS $/Enrollee

$3,958

Yearly Spending Trend

Year-over-Year Growth

Top Providers

Provider	Total Paid▼	Claims	Avg/Claim
SOUTH DAKOTA ACHIEVE Clinic/Center	$166.9M	419K	$398
BLACK HILLS WORKS INC Day Training, Developmentally Disabled Services	$149.6M	442K	$339
DAKOTABILITIES Voluntary or Charitable	$77.7M	48K	$1,620
HURON AREA CENTER FOR INDEPENDENCE Clinic/Center	$75.7M	72K	$1,052
SANFORD MEDICAL CENTER Surgery	$69.1M	1.5M	$46
CHILDRENS HOME SOCIETY OF SOUTH DAKOTA Psychiatric Residential Treatment Facility	$62.7M	8K	$7,469
VOLUNTEERS OF AMERICA, DAKOTAS Substance Abuse Rehabilitation Facility	$60.9M	82K	$741
SOUTHEASTERN BEHAVIORAL HEALTHCARE Clinic/Center	$59.2M	276K	$215
LIFEQUEST Day Training, Developmentally Disabled Services	$53.1M	74K	$722
ADJUSTMENT TRAINING CENTER, INC. Day Training, Developmentally Disabled Services	$40.3M	41K	$995
NORTHERN HILLS TRAINING CENTER, INC. Day Training, Developmentally Disabled Services	$39.3M	35K	$1,137
ABILITY BUILDING SERVICES, INC. Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$39.2M	33K	$1,174
HUMAN SERVICE AGENCY Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$39.0M	104K	$374
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL Clinic/Center	$37.3M	152K	$245
GREAT PLAINS TRIBAL CHAIRMEN'S HEALTH BOARD Clinic/Center	$36.4M	113K	$321
OUR HOME INC Residential Treatment Facility, Emotionally Disturbed Children	$35.3M	5K	$7,388
BLACK HILLS SPECIAL SERVICES COOPERATIVE Day Training, Developmentally Disabled Services	$33.7M	28K	$1,223
UNIVERSAL NURSING SERVICES, LTD Nursing Care	$33.2M	26K	$1,298
ADVANCE Case Management	$32.7M	36K	$907
RESOUCES FOR HUMAN DEVELOPMENT, INC. Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	$31.1M	12K	$2,503

20 rows

Top Procedures

Code	Description	Total Paid▼	Claims	Avg/Claim
T2016	Habil res waiver per diem	$662.6M	400K	$1,656
T2048	Bh ltc res r&b, per diem	$185.7M	101K	$1,840
T2020	Day habil waiver per diem	$177.6M	353K	$503
99213	Office o/p est low 20 min	$175.8M	1.7M	$104
S0281	Medical home, maintenance	$62.7M	149K	$422
99214	Office o/p est mod 30 min	$57.9M	771K	$75
T2031	Assist living waiver/diem	$46.1M	42K	$1,090
H2016	Comp comm supp svc, per diem	$39.5M	480K	$82
H2021	Com wrap-around sv, 15 min	$38.9M	439K	$89
T2025	Waiver service, nos	$35.3M	198K	$179
S5125	Attendant care service /15m	$32.8M	158K	$207
T1019	Personal care ser per 15 min	$29.5M	355K	$83
S5130	Homaker service nos per 15m	$29.2M	409K	$71
90837	Psytx w pt 60 minutes	$28.5M	323K	$88
T1016	Case management	$26.9M	499K	$54
S9123	Nursing care in home rn	$26.8M	21K	$1,261
H0019	Alcohol and/or drug services	$26.3M	17K	$1,546
J3490	Drugs unclassified injection	$23.3M	134K	$174
90999	Unlisted dialysis procedure	$20.0M	409K	$49
T1000	Private duty/independent nsg	$17.6M	148K	$119