Texas
#3 in Medicaid spending (5.14% of national total)
Total Spending
$56.23B
Total Claims
1.1B
Providers
31,254
Avg Cost/Claim
$51
Data Coverage Note: Texas has 93% of Medicaid enrollees in managed care. This data covers only fee-for-service (FFS) claims (est. 7% of enrollees). Actual total Medicaid spending in Texas is significantly higher than shown.
Enrollment (Latest)
4.4M
Managed Care
93%
ACA Expansion
Not Expanded
FFS $/Enrollee
$2,657
Yearly Spending Trend
Year-over-Year Growth
Top Providers
| Provider | Total Paid▼ |
|---|---|
GIRLING HEALTH CARE, INC. Respite Care | $858.2M |
AOC TX, LLC Case Management | $708.5M |
CONSUMER DIRECTED SERVICES IN TEXAS, INC. Home Health | $624.8M |
CAREGIVERS HOME HEALTH TX INC Nursing Care | $477.7M |
LEGACY COMMUNITY HEALTH SERVICES, INC Pediatrics | $406.5M |
ADVANCE HI-TECH NURSING, INC. Supports Brokerage | $399.8M |
TEXAS DEPARTMENT OF STATE HEALTH Clinical Medical Laboratory | $381.9M |
DISABILITY SERVICES OF THE SOUTHWEST, INC Day Training, Developmentally Disabled Services | $302.3M |
COOK CHILDREN'S MEDICAL CENTER Clinic/Center | $286.7M |
TEXAS CHILDREN'S HOSPITAL Clinic/Center | $277.3M |
QUEST DIAGNOSTICS CLINICAL LABORATORIES INC Clinical Medical Laboratory | $276.8M |
CHILDREN'S HEALTH SYSTEM OF TEXAS Behavior Analyst | $263.8M |
IN-HOME ATTENDANT SERVICES, LTD. Day Training, Developmentally Disabled Services | $261.2M |
CHARTWELL COMMUNITY SERVICES, INC. Technician | $253.4M |
HHSC WIC PROGRAM Pharmacy | $244.6M |
LEGACY HOME HEALTH AGENCY, INC. Home Health | $244.2M |
DAYBREAK COMMUNITY SERVICES TEXAS LLC Community/Behavioral Health | $243.2M |
TEXAS HOME HEALTH OF AMERICA, L.P. Day Training, Developmentally Disabled Services | $216.3M |
SAINT BENEDICTS HOME HEALTH, INC. Day Training, Developmentally Disabled Services | $201.0M |
HEALTHTRACKRX INDIANA, INC Clinical Medical Laboratory | $186.0M |
20 rows
Top Procedures
| Code | Description | Total Paid▼ |
|---|---|---|
| S5125 | Attendant care service /15m | $15.92B |
| T1000 | Private duty/independent nsg | $3.42B |
| H2016 | Comp comm supp svc, per diem | $2.39B |
| T1015 | Clinic service | $1.99B |
| T1019 | Personal care ser per 15 min | $1.92B |
| 99284 | Emergency dept visit mod mdm | $1.50B |
| 99213 | Office o/p est low 20 min | $1.41B |
| 92507 | Tx sp lang voice comm indiv | $1.18B |
| 99214 | Office o/p est mod 30 min | $903.8M |
| T2016 | Habil res waiver per diem | $879.8M |
| T2026 | Special childcare waiver/d | $817.0M |
| H2014 | Skills train and dev, 15 min | $778.3M |
| 99283 | Emergency dept visit low mdm | $748.1M |
| 99285 | Emergency dept visit hi mdm | $568.2M |
| 97530 | Therapeutic activities | $539.0M |
| T2046 | Hospice long term care, r&b | $487.9M |
| T1005 | Respite care service 15 min | $474.7M |
| S5101 | Adult day care per half day | $445.0M |
| D2392 | Post 2 srfc resinbased cmpst | $426.7M |
| A0100 | Nonemergency transport taxi | $410.3M |
20 rows
Provider Classification Breakdown
| Classification | Total Paid▼ | Providers |
|---|---|---|
| Home Health | $9.29B | 1,243 |
| Clinic/Center | $6.06B | 2,906 |
| Technician | $3.58B | 361 |
| Day Training, Developmentally Disabled Services | $3.27B | 183 |
| Dentist | $3.16B | 5,464 |
| Pediatrics | $2.62B | 1,323 |
| Nursing Care | $2.61B | 162 |
| Case Management | $2.11B | 219 |
| Durable Medical Equipment & Medical Supplies | $1.93B | 823 |
| Clinical Medical Laboratory | $1.76B | 436 |
| In Home Supportive Care | $1.61B | 163 |
| Local Education Agency (LEA) | $1.39B | 752 |
| Respite Care | $1.33B | 44 |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $1.17B | 115 |
| Community/Behavioral Health | $1.02B | 165 |
| Ambulance | $833.3M | 489 |
| Counselor | $766.1M | 1,460 |
| Hospice Care, Community Based | $736.1M | 252 |
| Supports Brokerage | $697.0M | 13 |
| Obstetrics & Gynecology | $608.6M | 529 |