Against 6 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$1,329
+29.9% vs peer median
1st highest of 7 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$24,810,177,871
9th highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
1,363,711
15th highest of 51 states
Most recent CMS monthly report
Visible in claims
37.2%
−4.6% vs peer median
6th highest of 7 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 30 flagged Massachusetts providers. Two show Medicaid payments recorded after an exclusion date; see the provider pages. 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.
$56.1B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $8.2B / year
790.6M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 115.7M / year
19.4K
Distinct billing NPIs, Jan 2018 – Oct 2024
1.1K
156 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $9.0B | 890.8K |
| T1019 | Personal care ser per 15 min | $8.4B | 97.0M |
| S5140 | Adult foster care per diem | $3.1B | 29.6M |
| S5102 | Adult day care per diem | $1.4B | 13.2M |
| 99214 | Office o/p est mod 30 min | $1.1B | 15.9M |
| 90834 | Psytx w pt 45 minutes | $969.9M | 12.7M |
| T1502 | Medication admin visit | $952.5M | 16.2M |
| 99213 | Office o/p est low 20 min | $875.3M | 15.6M |
| T2025 | Waiver service, nos | $864.7M | 5.4M |
| T1015 | Clinic service | $851.8M | 5.9M |