Against 13 peers — similar data coverage. Comparing to a named peer set rather than a 51-state average.
Spending per member/month
$972
−8.2% vs peer median
10th highest of 14 similar states
CMS-64 total ÷ CMS enrollment
Total Medicaid spending
$47,154,858,551
3rd highest of 51 states
CMS-64 Total Net, FY2024
Medicaid enrollment
3,643,702
3rd highest of 51 states
Most recent CMS monthly report
Visible in claims
27.3%
−7.0% vs peer median
10th 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 Texas providers; dental code D0120 at HCBS residential providers is under review as a likely coding artifact. 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.
$56.3B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ $8.2B / year
1.1B
Cumulative, Jan 2018 – Oct 2024 (6.8 years)
≈ 163.1M / year
31.4K
Distinct billing NPIs, Jan 2018 – Oct 2024
1.6K
377 highest/critical risk
Current (as of latest ETL)
| Code | Description | Total Paid | Claims |
|---|---|---|---|
| S5125 | Attendant care service /15m | $17.2B | 295.4M |
| T1000 | Private duty/independent nsg | $3.8B | 10.5M |
| H2016 | Comp comm supp svc, per diem | $3.8B | 30.2M |
| 99213 | Office o/p est low 20 min | $3.2B | 107.4M |
| 99284 | Emergency dept visit mod mdm | $2.8B | 38.5M |
| T1015 | Clinic service | $2.6B | 35.7M |
| T1019 | Personal care ser per 15 min | $1.7B | 95.4M |
| 92507 | Tx sp lang voice comm indiv | $1.4B | 16.0M |
| T2016 | Habil res waiver per diem | $1.3B | 9.2M |
| 99214 | Office o/p est mod 30 min | $1.3B | 53.8M |