Medical Transportation Management Inc.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 4 procedure codes: W6110 at 1.1× median, A0428 at 4.6× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Claims Per Patient
Filing an unusually high number of claims per beneficiary compared to peers.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
Unusually High Spending
Unusually High Spending means this provider's total Medicaid payments are significantly above the median for their specialty. This doesn't necessarily indicate fraud — high volume practices and those serving complex populations may legitimately bill more.
High Claims Per Patient
High Claims Per Patient means this provider files an unusually high number of claims per individual patient. This could indicate legitimate intensive treatment or a pattern of billing for services not actually rendered.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $268.54 per claim for A0428 (Ambulance service, BLS, non-emergency transport) — 4.6× the national median of $58.05.
Bills $10.08 per claim for A0170 — 3.3× the national median of $3.07.
Bills $41.57 per claim for A0888 — 64.0× the national median of $0.65.
Billing in the top 1% nationally for 1 procedure code: W6110.
This is a statistical summary, not an accusation. See our methodology.
Compared to Transportation Broker Peers
Total spending distribution among 12 providers in this specialty
This provider's total spending of $894.4M is at the 90th percentile among 12 Transportation Broker providers.
Above 90th percentile for this specialty — higher spending than 10 of 12 peers
Total Paid
$894.4M
$894,406,193
Total Claims
34.4M
Beneficiaries
5.0M
6.8 claims/patient
Avg Cost/Claim
$26
#42 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Medical Transportation Management Inc. is a Transportation Broker provider based in Lake St Louis, MO. From the 2018–2024 period, this provider received $894.4M in Medicaid payments across 34.4M claims.
Why This Matters
This provider received $894.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 111,800 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 21 distinct procedure codes. The top code (A0100 (Non-emergency transportation; per trip)) accounts for 44% of total spending.
$391.0M
16.9M claims
$23.18
$24.72
Non-emergency transportation; per trip
$391.0M
16.9M claims · 43.7%
$240.9M
2.3M claims
$105.67
$93.98
Waiver service, state-specific code
$240.9M
2.3M claims · 26.9%
$114.8M
2.4M claims
$47.37
$29.37
Non-emergency wheelchair van transport
$114.8M
2.4M claims · 12.8%
$39.9M
4.2M claims
$9.54
$10.45
Non-emergency transport, per mile
$39.9M
4.2M claims · 4.5%
$33.0M
2.3M claims
$14.07
$21.33
Non-invasive prenatal screening, fetal chromosomal abnormalities
$33.0M
2.3M claims · 3.7%
$15.2M
1.0M claims
$14.86
$21.70
Non-emergency transport; encounter/trip
$15.2M
1.0M claims · 1.7%
$13.6M
50K claims
$268.54
$58.05
Ambulance service, BLS, non-emergency transport
$13.6M
50K claims · 1.5%
$12.9M
1.3M claims · 1.4%
$12.6M
303K claims · 1.4%
Non-emergency taxi transport
$8.9M
3.2M claims · 1.0%
$5.0M
232K claims
$21.68
$8.80
Non-emergency transportation, commercial carrier, encounter trip
$5.0M
232K claims · 0.6%
$4.2M
25K claims · 0.5%
$893K
6K claims · 0.1%
$742K
10K claims · 0.1%
$463K
14K claims · 0.1%
$122K
786 claims
$155.40
$132.60
Non-emergency transportation, per diem
$122K
786 claims · 0.0%
$90K
664 claims · 0.0%
Ground mileage, per statute mile
$62K
2K claims · 0.0%
Non-emergency transport; per trip
$22K
5K claims · 0.0%
$214
112 claims · 0.0%
$42
169K claims
$0.00
$18.24
Outpatient psychiatric services, partial hospitalization, per hour
$42
169K claims · 0.0%
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