Virginia
#11 in Medicaid spending (2.7% of national total)
Total Spending
$29.49B
Total Claims
421.8M
Providers
15,631
Avg Cost/Claim
$70
Data Coverage Note: Virginia has 86% of Medicaid enrollees in managed care. This data covers only fee-for-service (FFS) claims (est. 14% of enrollees). Actual total Medicaid spending in Virginia is significantly higher than shown.
Enrollment (Latest)
1.8M
Managed Care
86%
ACA Expansion
Yes (2019)
FFS $/Enrollee
$2,866
Yearly Spending Trend
Year-over-Year Growth
Top Providers
| Provider | Total Paid▼ |
|---|---|
VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY Psychiatric Unit | $658.5M |
RECTOR & VISITORS OF THE UNIVERSITY OF VIRGINIA Clinical Medical Laboratory | $500.5M |
WALL RESIDENCES, LLC Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $481.6M |
HOME CARE DELIVERED, INC. Durable Medical Equipment & Medical Supplies | $309.5M |
CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC Social Worker | $288.2M |
MOUNT ROGERS COMMUNITY SERVICES Clinic/Center | $210.4M |
LUTHERAN FAMILY SERVICES OF VIRGINIA, INC. Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $194.3M |
NEW RIVER VALLEY COMMUNITY SERVICES Clinic/Center | $193.8M |
INOVA HEALTH CARE SERVICES Clinic/Center | $176.7M |
COMMUNITY ALTERNATIVES VIRGINIA, INC. Case Management | $172.7M |
FISHING POINT HEALTH CARE LLC Pharmacy | $169.8M |
GALAX TREATMENT CENTER, LLC Clinic/Center | $164.2M |
CAREPEOPLE HOME HEALTH, INC Hospice Care, Community Based | $163.1M |
AGAPE HEALTH MANAGEMENT INC Home Health | $158.5M |
RAPPAHANNOCK AREA COMMUNITY SERVICES BOARD Day Training, Developmentally Disabled Services | $142.6M |
HORIZON BEHAVIORAL HEALTH Community/Behavioral Health | $138.0M |
RIVERSIDE HOSPITAL INC Psychiatric Hospital | $136.8M |
RICHMOND BEHAVIORAL HEALTH AUTHORITY Counselor | $129.2M |
CARILION MEDICAL CENTER General Acute Care Hospital | $124.9M |
HAMPTON NEWPORT NEWS COMMUNITY SERVICES BOARD Clinic/Center | $123.8M |
20 rows
Top Procedures
| Code | Description | Total Paid▼ |
|---|---|---|
| T1019 | Personal care ser per 15 min | $4.18B |
| H2022 | Com wrap-around sv, per diem | $2.09B |
| H0046 | Mental health service, nos | $1.42B |
| T2033 | Res, nos waiver per diem | $1.19B |
| 99214 | Office o/p est mod 30 min | $988.1M |
| 99213 | Office o/p est low 20 min | $801.3M |
| H0023 | Alcohol and/or drug outreach | $747.8M |
| 99283 | Emergency dept visit low mdm | $668.5M |
| H2012 | Behav hlth day treat, per hr | $648.5M |
| 99284 | Emergency dept visit mod mdm | $627.7M |
| H2014 | Skills train and dev, 15 min | $510.4M |
| 97150 | Group therapeutic procedures | $488.6M |
| T1005 | Respite care service 15 min | $480.3M |
| 99285 | Emergency dept visit hi mdm | $446.9M |
| T1017 | Targeted case management | $431.6M |
| S9124 | Nursing care, in the home; b | $399.2M |
| T2003 | N-et; encounter/trip | $373.7M |
| 90837 | Psytx w pt 60 minutes | $327.8M |
| S9482 | Family stabilization 15 min | $311.3M |
| H2033 | Multisys ther/juvenile 15min | $294.1M |
20 rows
Provider Classification Breakdown
| Classification | Total Paid▼ | Providers |
|---|---|---|
| Clinic/Center | $3.71B | 1,243 |
| Home Health | $3.45B | 678 |
| Community/Behavioral Health | $3.01B | 565 |
| General Acute Care Hospital | $2.19B | 96 |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $1.60B | 75 |
| Counselor | $1.55B | 829 |
| Day Training, Developmentally Disabled Services | $997.7M | 110 |
| Psychiatric Unit | $694.4M | 5 |
| Dentist | $692.3M | 1,354 |
| Clinical Medical Laboratory | $679.2M | 78 |
| Case Management | $654.3M | 128 |
| Pediatrics | $638.0M | 955 |
| Durable Medical Equipment & Medical Supplies | $632.9M | 303 |
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $604.4M | 57 |
| In Home Supportive Care | $599.0M | 106 |
| Non-emergency Medical Transport (VAN) | $538.5M | 694 |
| Social Worker | $501.3M | 321 |
| Respite Care | $429.3M | 89 |
| Registered Nurse | $363.8M | 82 |
| Family Medicine | $342.7M | 820 |