Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

KY#12 of 49 states

Kentucky Medicaid Spending

Kentucky's Medicaid program paid $5.68B across 24 providers from 2018–2024. 21 providers in Kentucky are flagged on our risk watchlist. The top procedure code is 97535 (Self-care/home management training, per 15 minutes) at $670.1M.

Total Spending

$5.68B

Total Claims

77.5M

Top Providers

24

Beneficiaries

49.0M

Largest Provider

University of Kentucky

$716.4M

Top Procedure

97535

$670.1M

Flagged Providers

21

on risk watchlist

Avg Per Provider

$236.8M

across 24 providers

Yearly Spending Trend

Top Providers in Kentucky

1

University of Kentucky

General Acute Care Hospital · Lexington

$716.4M

8.8M claims

2

Norton Hospitals INC

General Acute Care Hospital · Louisville

$419.6M

5.9M claims

3

Seven Counties Services Inc.

Clinic/Center Developmental Disabilities · Louisville

$375.8M

2.7M claims

4

Cumberland River Behavioral Health INC

Community/Behavioral Health · Corbin

$349.2M

2.7M claims

5

Addiction Recovery Care LLC

Community Based Residential Treatment Facility, Me · Louisa

$309.0M

2.4M claims

6

Norton Hospitals, INC

General Acute Care Hospital · Louisville

$299.0M

3.2M claims

7

Uofl Health-louisville INC

Psychiatric Hospital · Louisville

$283.2M

4.5M claims

8

Mountain Comprehensive Care Center, Inc.

Counselor, Mental Health · Prestonsburg

$243.1M

2.6M claims

9

Ashland Hospital Corporation

Clinic/Center, Rural Health · Ashland

$222.8M

6.5M claims

10

Southeastern Emergency Physicians LLC

Emergency Medicine, Pediatric Emergency Medicine · Maysville

$208.9M

4.2M claims

11

Communicare INC

Community/Behavioral Health · Elizabethtown

$206.1M

1.8M claims

12

Seven Counties Services, Inc.

Counselor · Louisville

$194.2M

2.4M claims

13

St Elizabeth Medical Center, INC

Portable X-Ray and/or Other Portable Diagnostic Im · Edgewood

$188.3M

4.3M claims

14

Pikeville Medical Center INC

General Acute Care Hospital · Pikeville

$181.4M

4.3M claims

15

University Medical Center, INC

Student in an Organized Health Care Education/Trai · Louisville

$179.4M

2.4M claims

16

Lifeskills INC

Community/Behavioral Health · Bowling Green

$168.9M

1.4M claims

17

New Vista of the Bluegrass INC

Clinic/Center Mental Health (Including Community · Versailles

$166.4M

1.3M claims

18

Spero Health of Kentucky LLC

Family Medicine Addiction Medicine · Danville

$154.2M

2.6M claims

19

Owensboro Health INC

General Acute Care Hospital · Owensboro

$148.8M

3.3M claims

20

Freedom Senior Share, LLC

In Home Supportive Care · Louisville

$142.7M

1.1M claims

21

Lake Cumberland Reg Mhmr Board Inc.

Community/Behavioral Health · Somerset

$140.9M

899K claims

22

Community Medical Associates, Inc.

Clinical Neuropsychologist · Louisville

$135.3M

5.2M claims

23

Personal Touch Home Care of Ky, Inc.

Home Health · Fort Thomas

$127.2M

358K claims

24

Baptist Healthcare System INC

General Acute Care Hospital · Corbin

$121.5M

2.5M claims

Spending by Top Procedures

97535Self-care/home management training, per 15 minutes$670.1M
99284Emergency dept visit, high complexity$347.9M
T1019Personal care services, per 15 min$280.2M
99285Emergency dept visit, high/urgent complexity$264.6M
S5108Home care training to home care client, per 15 minutes$226.7M

Top Procedures in Kentucky

CodeTotal Paid
97535

Self-care/home management training, per 15 minutes

$670.1M
99284

Emergency dept visit, high complexity

$347.9M
T1019

Personal care services, per 15 min

$280.2M
99285

Emergency dept visit, high/urgent complexity

$264.6M
S5108

Home care training to home care client, per 15 minutes

$226.7M
99283

Emergency dept visit, moderate complexity

$215.4M
T2022

Case management, per month

$113.6M
90837

Psychotherapy, 60 minutes

$105.7M
T2023

Community transition, waiver; per service

$102.8M
H0011

Alcohol and/or drug services, acute detoxification, per diem

$94.0M
74177

CT abdomen and pelvis with contrast

$86.8M
T2016

Habilitation, residential, waiver; per diem

$86.0M
J9271

Injection, pembrolizumab, 1 mg

$77.3M
H2027

Psychoeducational service, per 15 minutes

$74.8M
99214

Office/outpatient visit, est. patient, mod-high complexity

$71.1M