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

Medical Transportation Management Inc.

Transportation Broker·Lake St Louis, MO·NPI: 1134260078SharePrint Report

Red Flags Explained

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

Billing Velocity18608.5 claims/working day

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

P25MedianP75P90

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

Active Billing Period:2018-012024-12(84 months)

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.

51% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$98.5M
+9%
2019
$107.8M
-9%
2020
$97.6M
+16%
2021
$113.6M
+43%
2022
$161.9M
+3%
2023
$166.5M
-11%
2024
$148.5M

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.

A0100Normal range

Non-emergency transportation; per trip

$391.0M

16.9M claims · 43.7%

Your Cost: $23.18/claim|Median: $24.72
0.9× median
W6110Top 1%

Waiver service, state-specific code

$240.9M

2.3M claims · 26.9%

Your Cost: $105.67/claim|Median: $93.98
1.1× median
A0130Normal range

Non-emergency wheelchair van transport

$114.8M

2.4M claims · 12.8%

Your Cost: $47.37/claim|Median: $29.37
1.6× median
A0090Normal range

Non-emergency transport, per mile

$39.9M

4.2M claims · 4.5%

Your Cost: $9.54/claim|Median: $10.45
0.9× median
S0215Normal range

Non-invasive prenatal screening, fetal chromosomal abnormalities

$33.0M

2.3M claims · 3.7%

Your Cost: $14.07/claim|Median: $21.33
0.7× median
T2003Normal range

Non-emergency transport; encounter/trip

$15.2M

1.0M claims · 1.7%

Your Cost: $14.86/claim|Median: $21.70
0.7× median
A0428Top 5%

Ambulance service, BLS, non-emergency transport

$13.6M

50K claims · 1.5%

Your Cost: $268.54/claim|Median: $58.05
4.6× median
A0170Top 25%

$12.9M

1.3M claims · 1.4%

Your Cost: $10.08/claim|Median: $3.07
3.3× median
A0888Top 10%

$12.6M

303K claims · 1.4%

Your Cost: $41.57/claim|Median: $0.65
64.0× median
A0110Normal range

Non-emergency taxi transport

$8.9M

3.2M claims · 1.0%

Your Cost: $2.82/claim|Median: $9.27
0.3× median
T2004Normal range

Non-emergency transportation, commercial carrier, encounter trip

$5.0M

232K claims · 0.6%

Your Cost: $21.68/claim|Median: $8.80
2.5× median
A0180Normal range

$4.2M

25K claims · 0.5%

Your Cost: $171.57/claim|Median: $131.03
1.3× median
A0200Normal range

$893K

6K claims · 0.1%

Your Cost: $153.54/claim|Median: $122.06
1.3× median
A0210Top 25%

$742K

10K claims · 0.1%

Your Cost: $73.66/claim|Median: $24.29
3.0× median
A0190Top 25%

$463K

14K claims · 0.1%

Your Cost: $32.17/claim|Median: $13.78
2.3× median
T2005Normal range

Non-emergency transportation, per diem

$122K

786 claims · 0.0%

Your Cost: $155.40/claim|Median: $132.60
1.2× median
T2049Top 5%

$90K

664 claims · 0.0%

Your Cost: $135.50/claim|Median: $10.10
13.4× median
A0425Normal range

Ground mileage, per statute mile

$62K

2K claims · 0.0%

Your Cost: $38.95/claim|Median: $23.36
1.7× median
T2002Normal range

Non-emergency transport; per trip

$22K

5K claims · 0.0%

Your Cost: $4.73/claim|Median: $19.35
0.2× median
A0080Normal range

$214

112 claims · 0.0%

Your Cost: $1.91/claim|Median: $26.51
0.1× median
S0209Normal range

Outpatient psychiatric services, partial hospitalization, per hour

$42

169K claims · 0.0%

Your Cost: $0.00/claim|Median: $18.24
0.0× median