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

WI#29 of 49 states

Wisconsin Medicaid Spending

Wisconsin's Medicaid program paid $1.68B across 9 providers from 2018–2024. 9 providers in Wisconsin are flagged on our risk watchlist. The top procedure code is H2017 (Psychosocial rehabilitation services, per 15 min) at $368.5M.

Total Spending

$1.68B

Total Claims

32.4M

Top Providers

9

Beneficiaries

22.4M

Largest Provider

Exact Sciences Laboratories LLC

$276.5M

Top Procedure

H2017

$368.5M

Flagged Providers

9

on risk watchlist

Avg Per Provider

$187.1M

across 9 providers

Yearly Spending Trend

Spending by Top Procedures

H2017Psychosocial rehabilitation services, per 15 min$368.5M
81528Oncology, colorectal screening, quantitative analysis of stool DNA$276.2M
T2016Habilitation, residential, waiver; per diem$82.7M
99213Office/outpatient visit, est. patient, low-mod complexity$75.2M
99199Unlisted special service, procedure, or report$52.5M

Top Procedures in Wisconsin

CodeTotal Paid
H2017

Psychosocial rehabilitation services, per 15 min

$368.5M
81528

Oncology, colorectal screening, quantitative analysis of stool DNA

$276.2M
T2016

Habilitation, residential, waiver; per diem

$82.7M
99213

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

$75.2M
99199

Unlisted special service, procedure, or report

$52.5M
99214

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

$50.5M
99283

Emergency dept visit, moderate complexity

$41.0M
99284

Emergency dept visit, high complexity

$32.8M
99211

Office/outpatient visit, minimal complexity

$30.8M
96361

IV infusion, hydration, each additional hour

$25.9M
99212

Office/outpatient visit, low complexity

$24.9M
80053

Comprehensive metabolic panel

$18.2M
S5140

Foster care, adult; per diem

$14.9M
99282

Emergency dept visit, low complexity

$14.4M
99285

Emergency dept visit, high/urgent complexity

$14.1M