Against 23 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$1,056
+6.3% vs peer median
7th highest of 24 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$3,893,210,477
40th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
294,322
40th highest of 51 states
Most recent CMS monthly report
Visible in claims
15.3%
−27.3% vs peer median
24th highest of 24 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 22 flagged Idaho providers. No referrals and no badges; Idaho's April 2023 developmental-disability rate increase and timed-code unit stacking explain the benign findings, and the state's enforcement record since 2024 names no provider present in the source data. 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.
$3.6B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $521.2M / year
63.2M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 9.3M / year
3.3K
Distinct billing NPIs, Jan 2018 – Oct 2024
164
12 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T1015 | Clinic service | $380.7M | 2.1M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | $255.5M | 1.8M |
| T1019 | Personal care ser per 15 min | $202.7M | 2.7M |
| 99213 | Office o/p est low 20 min | $129.6M | 3.2M |
| H2022 | Com wrap-around sv, per diem | $124.7M | 151.2K |
| 99214 | Office o/p est mod 30 min | $118.9M | 2.1M |
| 97530 | Therapeutic activities | $109.8M | 1.6M |
| H2016 | Comp comm supp svc, per diem | $107.4M | 62.4K |
| T2016 | Habil res waiver per diem | $105.5M | 274.5K |
| S5125 | Attendant care service /15m | $104.7M | 936.0K |