West Virginia
#32 in Medicaid spending (0.78% of national total)
Total Spending
$8.56B
Total Claims
121.5M
Providers
3,746
Avg Cost/Claim
$70
Data Coverage Note: West Virginia has 87% of Medicaid enrollees in managed care. This data covers only fee-for-service (FFS) claims (est. 13% of enrollees). Actual total Medicaid spending in West Virginia is significantly higher than shown.
Enrollment (Latest)
523K
Managed Care
87%
ACA Expansion
Yes (2014)
FFS $/Enrollee
$2,064
Yearly Spending Trend
Year-over-Year Growth
Top Providers
| Provider | Total Paid▼ |
|---|---|
REM COMMUNITY OPTIONS, INC. Community/Behavioral Health | $224.9M |
LABORATORY CORPORATION OF AMERICA HOLDINGS Clinical Medical Laboratory | $220.0M |
CHARLESTON AREA MEDICAL CENTER INC General Acute Care Hospital | $199.8M |
VOCA CORPORATION OF WEST VIRGINIA, INC. Clinic/Center | $178.3M |
MULBERRY STREET MANAGEMENT SERVICES, INC. Case Management | $175.6M |
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION Anesthesiology | $162.0M |
RSCR WEST VIRGINIA, INC. Clinic/Center | $153.6M |
WEST VIRGINIA UNIVERSITY HOSPITALS, INC Clinical Medical Laboratory | $124.1M |
DIVERSIFIED ASSESSMENT & THERAPY SERVICES Community/Behavioral Health | $122.7M |
CABELL HUNTINGTON HOSPITAL INC General Acute Care Hospital | $94.2M |
PRESTERA CENTER FOR MENTAL HEALTH SERVICES INC Community/Behavioral Health | $75.4M |
WEST VIRGINIA'S CHOICE Home Health | $72.8M |
NORTHWOOD HEALTH SYSTEMS INC Day Training, Developmentally Disabled Services | $67.6M |
URGENT CARE, INC.- WEST VIRGINIA Emergency Medicine | $67.0M |
LINX COMMUNITY SERVICE, LLC Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | $64.5M |
UNITED HOSPITAL CENTER, INC General Acute Care Hospital | $63.3M |
CENTRAL WEST VIRGINIA AGING SERVICES INC (HMKR) Home Health | $61.8M |
SHENANDOAH VALLEY MEDICAL SYSTEM, INC. Clinic/Center | $61.2M |
WV BIRTH TO THREE Early Intervention Provider Agency | $60.0M |
AUTISM SERVICE CENTER Clinic/Center | $59.0M |
20 rows
Top Procedures
| Code | Description | Total Paid▼ |
|---|---|---|
| S5125 | Attendant care service /15m | $1.31B |
| T1015 | Clinic service | $859.6M |
| S5130 | Homaker service nos per 15m | $475.7M |
| T1019 | Personal care ser per 15 min | $364.6M |
| 99213 | Office o/p est low 20 min | $313.5M |
| H2036 | A/d tx program, per diem | $273.3M |
| H0004 | Alcohol and/or drug services | $246.6M |
| 99214 | Office o/p est mod 30 min | $229.3M |
| 99285 | Emergency dept visit hi mdm | $192.4M |
| 99284 | Emergency dept visit mod mdm | $186.3M |
| H0019 | Alcohol and/or drug services | $143.7M |
| A0425 | Ground mileage | $131.0M |
| T2021 | Day habil waiver per 15 min | $125.2M |
| 99283 | Emergency dept visit low mdm | $116.5M |
| G9002 | Mccd,maintenance rate | $110.9M |
| H0020 | Alcohol and/or drug services | $93.5M |
| H0038 | Self-help/peer svc per 15min | $89.6M |
| H0040 | Assert comm tx pgm per diem | $82.0M |
| A0429 | Bls-emergency | $79.5M |
| A0427 | Als1-emergency | $70.1M |
20 rows
Provider Classification Breakdown
| Classification | Total Paid▼ | Providers |
|---|---|---|
| Clinic/Center | $1.53B | 549 |
| Community/Behavioral Health | $1.11B | 93 |
| General Acute Care Hospital | $1.08B | 54 |
| Clinical Medical Laboratory | $412.1M | 36 |
| Home Health | $395.9M | 75 |
| Ambulance | $339.1M | 133 |
| Case Management | $331.3M | 72 |
| Dentist | $281.8M | 365 |
| Counselor | $243.1M | 106 |
| Family Medicine | $230.3M | 218 |
| Anesthesiology | $205.4M | 22 |
| Day Training, Developmentally Disabled Services | $169.4M | 19 |
| Durable Medical Equipment & Medical Supplies | $158.0M | 191 |
| Internal Medicine | $131.6M | 216 |
| Residential Treatment Facility, Emotionally Disturbed Children | $106.5M | 28 |
| Respite Care | $99.5M | 4 |
| Emergency Medicine | $99.3M | 88 |
| Nursing Care | $92.1M | 13 |
| Substance Abuse Rehabilitation Facility | $90.4M | 9 |
| Psychiatry & Neurology | $85.5M | 44 |