Against 13 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$990
−6.5% vs peer median
8th highest of 14 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$13,754,375,105
23rd highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
1,054,146
24th highest of 51 states
Most recent CMS monthly report
Visible in claims
30.7%
+9.2% vs peer median
5th highest of 14 similar states
Share of program these claims see
Published figures are FY2024 CMS-64 and CMS enrollment. Claims figures cover 2018–2024.
Public-record research has been run on 34 flagged Colorado providers, including 4 seeded from the state's enforcement record. Three referrals: a federal genetic-testing kickback indictment, a Medicaid kickback indictment, and a drug-felony exclusion. Colorado's July 1, 2024 cost-based payment system for community mental health centers explains the largest step changes. Methodology
CMS T-MSIS data, 2018-2024
Concourse Sentinel connects to large-scale healthcare billing datasets — including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists — and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.
$21.6B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $3.2B / year
342.4M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 50.1M / year
12.3K
Distinct billing NPIs, Jan 2018 – Oct 2024
1.3K
173 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $2.4B | 8.2M |
| T1019 | Personal care ser per 15 min | $1.7B | 10.7M |
| A0100 | Nonemergency transport taxi | $1.3B | 38.9M |
| H0038 | Self-help/peer svc per 15min | $1.3B | 6.2M |
| 99213 | Office o/p est low 20 min | $896.3M | 9.4M |
| 99214 | Office o/p est mod 30 min | $716.4M | 8.0M |
| A0130 | Noner transport wheelch van | $664.5M | 14.1M |
| T2021 | Day habil waiver per 15 min | $658.5M | 4.0M |
| S5130 | Homaker service nos per 15m | $406.2M | 4.9M |
| 90837 | Psytx w pt 60 minutes | $386.2M | 3.8M |