Against 13 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$1,059
+7.0% vs peer median
7th highest of 14 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$15,891,669,916
21st highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
1,113,547
22nd highest of 51 states
Most recent CMS monthly report
Visible in claims
34.5%
+22.6% vs peer median
3rd 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 30 flagged Missouri providers. One referral rests on a federal guilty plea; two exclusions and one admitted-billing settlement are confirmed. Missouri's October 2022 residential per-diem migration and July 2022 rate rebasing explain most 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.
$28.0B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $4.1B / year
346.1M
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 50.7M / year
15.7K
Distinct billing NPIs, Jan 2018 – Oct 2024
951
92 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $6.2B | 74.3M |
| T2016 | Habil res waiver per diem | $5.2B | 11.6M |
| T1040 | Comm bh clinic svc per diem | $3.9B | 15.0M |
| T2021 | Day habil waiver per 15 min | $905.0M | 4.9M |
| A0100 | Nonemergency transport taxi | $866.2M | 39.8M |
| G9012 | Other specified case mgmt | $645.0M | 10.2M |
| 99213 | Office o/p est low 20 min | $479.9M | 8.5M |
| 99214 | Office o/p est mod 30 min | $407.6M | 6.0M |
| X4011 | Code X4011 | $345.4M | 1.0M |
| T1000 | Private duty/independent nsg | $338.9M | 1.1M |